Provider Demographics
NPI:1508454265
Name:SIMS PHARMACY LLC
Entity Type:Organization
Organization Name:SIMS PHARMACY LLC
Other - Org Name:MAC'S LTC PHARMACY GULF BREEZE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHOIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-677-9340
Mailing Address - Street 1:1614 E LAMAR ALEXANDER PKWY
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-6206
Mailing Address - Country:US
Mailing Address - Phone:865-273-0993
Mailing Address - Fax:865-238-2755
Practice Address - Street 1:1177 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4835
Practice Address - Country:US
Practice Address - Phone:850-677-9340
Practice Address - Fax:850-677-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy