Provider Demographics
NPI:1083935241
Name:SIMMONS, TOMMY FRANCIS (RPH)
Entity Type:Individual
Prefix:
First Name:TOMMY
Middle Name:FRANCIS
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 DICK POND RD
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29575-5510
Mailing Address - Country:US
Mailing Address - Phone:843-650-6800
Mailing Address - Fax:843-215-6155
Practice Address - Street 1:529 NAUTILUS DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7031
Practice Address - Country:US
Practice Address - Phone:843-616-4018
Practice Address - Fax:843-650-1032
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist