Provider Demographics
NPI:1689957318
Name:SIMPSON, RENE E (BS PHARM)
Entity Type:Individual
Prefix:MS
First Name:RENE
Middle Name:E
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:BS PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 BRASELTON HWY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-5215
Mailing Address - Country:US
Mailing Address - Phone:678-546-7320
Mailing Address - Fax:678-546-8013
Practice Address - Street 1:2630 BRASELTON HWY
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-5215
Practice Address - Country:US
Practice Address - Phone:678-546-7320
Practice Address - Fax:678-546-8013
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist