Provider Demographics
NPI:1851988588
Name:SIMS, LEROY JR
Entity Type:Individual
Prefix:MR
First Name:LEROY
Middle Name:
Last Name:SIMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22411 FAIRLAWN CIR APT 2
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2234
Mailing Address - Country:US
Mailing Address - Phone:216-835-3911
Mailing Address - Fax:
Practice Address - Street 1:22411 FAIRLAWN CIR APT 2
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2234
Practice Address - Country:US
Practice Address - Phone:216-835-3911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker