Provider Demographics
NPI:1164943288
Name:SIMPSON, ANGELA RENAE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:RENAE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 10TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-4455
Mailing Address - Country:US
Mailing Address - Phone:256-338-8600
Mailing Address - Fax:
Practice Address - Street 1:15445 AL HIGHWAY 24
Practice Address - Street 2:
Practice Address - City:MOULTON
Practice Address - State:AL
Practice Address - Zip Code:35650-6602
Practice Address - Country:US
Practice Address - Phone:256-974-1597
Practice Address - Fax:256-974-4699
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16946183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist