1689621732 NPI number — DR. CAROL A SIMS AND ASSOCIATES, LLC.

Table of content: (NPI 1689621732)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689621732 NPI number — DR. CAROL A SIMS AND ASSOCIATES, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. CAROL A SIMS AND ASSOCIATES, LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689621732
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21500 QUICK FOX LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAYTONSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20882-1340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-888-2239
Provider Business Mailing Address Fax Number:
301-296-4451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21500 QUICK FOX LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAYTONSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20882-1340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-888-2239
Provider Business Practice Location Address Fax Number:
301-296-4451
Provider Enumeration Date:
05/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SINGER
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
240-888-2239

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  01959 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001809024 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 884ACA . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 049451800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 079712 . This is a "VALUEOPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7445805 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0177-0001 . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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