Provider Demographics
NPI:1376556522
Name:SIM USA, INCORPORATED
Entity Type:Organization
Organization Name:SIM USA, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:PAGAN
Authorized Official - Last Name:HOPE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:704-587-1415
Mailing Address - Street 1:PO BOX 7900
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28241-7900
Mailing Address - Country:US
Mailing Address - Phone:704-587-1415
Mailing Address - Fax:704-587-1554
Practice Address - Street 1:14830 CHOATE CIRCLE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273
Practice Address - Country:US
Practice Address - Phone:704-587-1415
Practice Address - Fax:704-587-1554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC19168251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
7863826OtherAETNA FRANK A YOUNG
NC31411OtherNC # FRANK YOUNG
4074608OtherAETNA HAROLD HOPE MD
3401036727OtherCLIA # SIM
4074608OtherAETNA HAROLD HOPE MD
1088980OtherDEA # BY FRANK A YOUNG MD
3401036727OtherCLIA # SIM
4074608OtherAETNA HAROLD HOPE MD
=========OtherTAX ID SIM
NC31411OtherNC # FRANK YOUNG
4074608OtherAETNA HAROLD HOPE MD
C84575Medicare UPIN