Provider Demographics
NPI:1053537829
Name:SIMS, HAL W (RPH)
Entity type:Individual
Prefix:
First Name:HAL
Middle Name:W
Last Name:SIMS
Suffix:
Gender:M
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:PO BOX 7338
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO
Mailing Address - State:NM
Mailing Address - Zip Code:88355-7338
Mailing Address - Country:US
Mailing Address - Phone:505-437-7595
Mailing Address - Fax:505-434-3237
Practice Address - Street 1:1301 10TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5804
Practice Address - Country:US
Practice Address - Phone:505-437-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3896183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM3896OtherSTATE PHARMACIST LICENSE