Provider Demographics
NPI:1851545834
Name:SIMAC PROFESSIONAL BUSINESS SERVICES, INC.
Entity Type:Organization
Organization Name:SIMAC PROFESSIONAL BUSINESS SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:MACDOLD
Authorized Official - Last Name:ACOLATSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-432-3328
Mailing Address - Street 1:6000 BASS LAKE RD
Mailing Address - Street 2:SUITE #213
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55429-2700
Mailing Address - Country:US
Mailing Address - Phone:763-432-3328
Mailing Address - Fax:
Practice Address - Street 1:6000 BASS LAKE RD
Practice Address - Street 2:SUITE # 213
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55429-2700
Practice Address - Country:US
Practice Address - Phone:763-432-3328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN342169251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health