Provider Demographics
NPI:1548869746
Name:SIMS, AZA
Entity type:Individual
Prefix:
First Name:AZA
Middle Name:
Last Name:SIMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GOOD
Other - Middle Name:
Other - Last Name:SAMARITAN HOME CARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:30 S 15TH ST FL 15
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4806
Mailing Address - Country:US
Mailing Address - Phone:215-582-4285
Mailing Address - Fax:
Practice Address - Street 1:30 S 15TH ST FL 15
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4806
Practice Address - Country:US
Practice Address - Phone:215-964-4335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-20
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health