Provider Demographics
NPI:1518674878
Name:SIMPLY E CONNECT
Entity Type:Organization
Organization Name:SIMPLY E CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-814-2361
Mailing Address - Street 1:2236 CAPITAL CIR NE STE 205
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-8304
Mailing Address - Country:US
Mailing Address - Phone:800-814-2361
Mailing Address - Fax:
Practice Address - Street 1:4679 CRAWFORDVILLE HWY
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-4539
Practice Address - Country:US
Practice Address - Phone:850-926-7181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty