Provider Demographics
NPI:1982811295
Name:SIMS, RANDALL J (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:J
Last Name:SIMS
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29A MELISSA WAY
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-1985
Mailing Address - Country:US
Mailing Address - Phone:603-366-4314
Mailing Address - Fax:
Practice Address - Street 1:683 TENNEY MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3161
Practice Address - Country:US
Practice Address - Phone:603-536-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNHR1397183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist