MEDICARE: DR. DEIDRA M SIMPSON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	011631	KY
2	1835P1200X	Pharmacotherapy Pharmacist	0202206955	VA

General Provider Information

NPI Number	:	1194413856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEIDRA M SIMPSON PHARMD

Provider Business Mailing Address
First Line	:	650 RUSSELL SPRINGS DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24501-7291
Country	:	US
Telephone Number	:	434-485-4491
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 RUSSELL SPRINGS DR
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24501-7291
Country	:	US
Telephone Number	:	434-485-4491
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2023
Last Update Date	:	04/28/2023

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