Provider Demographics
NPI:1497363139
Name:SIMPLE BRANDS LLC
Entity Type:Organization
Organization Name:SIMPLE BRANDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PENDARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-325-1111
Mailing Address - Street 1:128 MILLPORT CIR STE 247
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5571
Mailing Address - Country:US
Mailing Address - Phone:864-315-1762
Mailing Address - Fax:
Practice Address - Street 1:128 MILLPORT CIR STE 247
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5571
Practice Address - Country:US
Practice Address - Phone:864-315-1762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCIHCO-1222OtherSCDHEC