Provider Demographics
NPI:1336565464
Name:SIMPSON, AUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:A.J.
Other - Middle Name:
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:871 BAYSHORE LN
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:SC
Mailing Address - Zip Code:29369-8610
Mailing Address - Country:US
Mailing Address - Phone:864-809-1055
Mailing Address - Fax:
Practice Address - Street 1:320 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1521
Practice Address - Country:US
Practice Address - Phone:846-877-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36067183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCI-7802OtherSOUTH CAROLINA PHARMACY CERTIFICATE OF INTERNSHIP