Provider Demographics
NPI:1164455341
Name:SIMS PHARMACY INC
Entity Type:Organization
Organization Name:SIMS PHARMACY INC
Other - Org Name:BOWDON VALU-RITE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:AKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-258-3366
Mailing Address - Street 1:301 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BOWDON
Mailing Address - State:GA
Mailing Address - Zip Code:30108-1309
Mailing Address - Country:US
Mailing Address - Phone:770-258-3366
Mailing Address - Fax:770-258-3366
Practice Address - Street 1:301 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BOWDON
Practice Address - State:GA
Practice Address - Zip Code:30108-1309
Practice Address - Country:US
Practice Address - Phone:770-258-3366
Practice Address - Fax:770-258-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE0059173336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000661218AMedicaid
AL100100071Medicaid
GAQ1333830001OtherMEDICARE
GAPHRE005917OtherSTATE PHARMACY LICENSE