Provider Demographics
NPI:1184082372
Name:SIMS, MARLA (PHARMD)
Entity type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 GATEWAY CROSSINGS
Mailing Address - Street 2:
Mailing Address - City:RADCLIFF
Mailing Address - State:KY
Mailing Address - Zip Code:40160
Mailing Address - Country:US
Mailing Address - Phone:270-351-3625
Mailing Address - Fax:
Practice Address - Street 1:102 GATEWAY CROSSINGS
Practice Address - Street 2:
Practice Address - City:RADCLIFF
Practice Address - State:KY
Practice Address - Zip Code:40160
Practice Address - Country:US
Practice Address - Phone:270-351-3625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY016083183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist