Provider Demographics
NPI:1992805790
Name:SIMPSON, CHRIS M (RPH)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:M
Last Name:SIMPSON
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 1:209 N VERNON ST
Mailing Address - Street 2:PO BOX 608
Mailing Address - City:CONRAD
Mailing Address - State:IA
Mailing Address - Zip Code:50621
Mailing Address - Country:US
Mailing Address - Phone:641-366-3153
Mailing Address - Fax:
Practice Address - Street 1:110 E CENTER ST
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:IA
Practice Address - Zip Code:50621
Practice Address - Country:US
Practice Address - Phone:641-366-2441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17662183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist