Provider Demographics
NPI:1841450483
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:COO
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GARY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:601-847-7125
Mailing Address - Street 1:P.O. BOX 580
Mailing Address - Street 2:
Mailing Address - City:PUCKETT
Mailing Address - State:MS
Mailing Address - Zip Code:39151
Mailing Address - Country:US
Mailing Address - Phone:601-824-9490
Mailing Address - Fax:601-824-5855
Practice Address - Street 1:6455 HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042
Practice Address - Country:US
Practice Address - Phone:601-824-9490
Practice Address - Fax:601-824-5855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIMPSON COMMUNITY HEALTHCARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-16
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health