Provider Demographics
NPI:1538445366
Name:SIMMONS, MYRA BETH (RPH)
Entity type:Individual
Prefix:MS
First Name:MYRA
Middle Name:BETH
Last Name:SIMMONS
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 1:245 MACON PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1708
Mailing Address - Country:US
Mailing Address - Phone:828-369-2970
Mailing Address - Fax:
Practice Address - Street 1:245 MACON PLAZA DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-1708
Practice Address - Country:US
Practice Address - Phone:828-369-2970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist