Provider Demographics
NPI:1871809327
Name:SIMS, LESLIE A (RPH)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:A
Last Name:SIMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:HUEYTOWN
Mailing Address - State:AL
Mailing Address - Zip Code:35023-1614
Mailing Address - Country:US
Mailing Address - Phone:205-491-1894
Mailing Address - Fax:205-497-4220
Practice Address - Street 1:220 FOREST RD
Practice Address - Street 2:
Practice Address - City:HUEYTOWN
Practice Address - State:AL
Practice Address - Zip Code:35023-1614
Practice Address - Country:US
Practice Address - Phone:205-491-1894
Practice Address - Fax:205-497-4220
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-22
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist