Provider Demographics
NPI:1124156781
Name:SIMCICH, ALAN F (RPH)
Entity type:Individual
Prefix:MR
First Name:ALAN
Middle Name:F
Last Name:SIMCICH
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 1:2076 ASCOTT RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2102
Mailing Address - Country:US
Mailing Address - Phone:561-626-1972
Mailing Address - Fax:561-842-1588
Practice Address - Street 1:228 U.S. HWY ONE
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403
Practice Address - Country:US
Practice Address - Phone:561-844-1191
Practice Address - Fax:564-842-1588
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist