Kelley Marie Simms
Individual provider Active NPI Pharmacist · Winterhaven, CA
NPI 1487713178 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487713178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03225204 (OH)
- Practice address
- One Indian Hill Road
Winterhaven, CA 92283 - Phone
- (760) 572-4120
- Fax
- (760) 572-2133
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03225204 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03225204 | OH | Yes |
Addresses
Primary practice location
One Indian Hill Road
Winterhaven, CA 92283
Mailing address
PO Box 1368
Yuma, AZ 85366-1368
Phone (760) 572-4120
Other providers in Winterhaven, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.