Provider Demographics
NPI:1720309636
Name:SIMMONS, BRANDON JAMES (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:JAMES
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 KITTREDGE ST
Mailing Address - Street 2:2225
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5752
Mailing Address - Country:US
Mailing Address - Phone:608-239-7624
Mailing Address - Fax:
Practice Address - Street 1:16601 E CENTRETECH PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-9045
Practice Address - Country:US
Practice Address - Phone:303-739-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO187201835P0018X
WI15607040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist