Provider Demographics
NPI:1689799207
Name:SIMPSON COMMUNITY HEALTHCARE INC.
Entity Type:Organization
Organization Name:SIMPSON COMMUNITY HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CCO BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-847-7130
Mailing Address - Street 1:1842 SIMPSON HIGHWAY 149
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-3438
Mailing Address - Country:US
Mailing Address - Phone:601-847-7130
Mailing Address - Fax:601-847-7104
Practice Address - Street 1:1842 SIMPSON HIGHWAY 149
Practice Address - Street 2:
Practice Address - City:MENDENHALL
Practice Address - State:MS
Practice Address - Zip Code:39114-3438
Practice Address - Country:US
Practice Address - Phone:601-847-7130
Practice Address - Fax:601-847-7104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMPSON COUMMUNITY HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-20
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS13216275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00029167Medicaid
MS00029167Medicaid