Provider Demographics
NPI:1902376676
Name:SOUTHERN STATE ELECTRIC & PLUMBING
Entity Type:Organization
Organization Name:SOUTHERN STATE ELECTRIC & PLUMBING
Other - Org Name:SOUTHERN TRUST HOME SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROJECT COORDINAROR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHLEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-343-4348
Mailing Address - Street 1:5205 STARKEY RD APT B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-9366
Mailing Address - Country:US
Mailing Address - Phone:540-343-4348
Mailing Address - Fax:540-772-2549
Practice Address - Street 1:5205 STARKEY RD APT B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-9366
Practice Address - Country:US
Practice Address - Phone:540-343-4348
Practice Address - Fax:540-772-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541851456OtherHOME MODIFICATION