Provider Demographics
NPI:1740776780
Name:SIMPSON, ROXANA (RPH)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-2237
Mailing Address - Country:US
Mailing Address - Phone:203-597-1498
Mailing Address - Fax:844-441-6473
Practice Address - Street 1:240 CHASE AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-2237
Practice Address - Country:US
Practice Address - Phone:203-597-1498
Practice Address - Fax:844-441-6473
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist