Provider Demographics
NPI:1689953689
Name:SIMS PHARMACY INC
Entity Type:Organization
Organization Name:SIMS PHARMACY INC
Other - Org Name:SOUTHEASTERN LONG TERM CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP SEC
Authorized Official - Prefix:
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:
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 STE B
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:770-258-9840
Practice Address - Street 1:301 W COLLEGE ST STE B
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:770-258-9840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X
GAPHRE0097803336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134597OtherPK