Provider Demographics
NPI:1356427843
Name:SIMPSON COMMUNITY HEALTHCARE, INC
Entity type:Organization
Organization Name:SIMPSON COMMUNITY HEALTHCARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF FINANCIAL OFFICIER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEDGEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-847-7136
Mailing Address - Street 1:1842 SIMPSON HWY 149
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-0000
Mailing Address - Country:US
Mailing Address - Phone:601-847-7136
Mailing Address - Fax:
Practice Address - Street 1:1865 SIMPSON HIGHWAY 469
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MS
Practice Address - Zip Code:39073-7430
Practice Address - Country:US
Practice Address - Phone:601-847-7744
Practice Address - Fax:601-847-7122
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMPSON COMMUNITY HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-27
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07472704Medicaid
MS258535Medicare Oscar/Certification