Provider Demographics
NPI:1942715404
Name:SIMPRA ADVANTAGE, INC.
Entity Type:Organization
Organization Name:SIMPRA ADVANTAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-320-7575
Mailing Address - Street 1:3008 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3503
Mailing Address - Country:US
Mailing Address - Phone:205-320-7575
Mailing Address - Fax:205-320-7595
Practice Address - Street 1:3008 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3503
Practice Address - Country:US
Practice Address - Phone:205-320-7575
Practice Address - Fax:205-320-7595
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSOCIATED CARE VENTURES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-06
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization