MEDICARE: SIMERSON INDUSTRIES LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251E00000X	Home Health Agency
3	332B00000X	Durable Medical Equipment & Medical Supplies
4	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1558962787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMERSON INDUSTRIES LLC.

Provider Business Mailing Address
First Line	:	41765 LARGO
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-9009
Country	:	US
Telephone Number	:	619-723-7638
Fax Number	:

Provider Business Practice Location Address
First Line	:	41765 LARGO
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-9009
Country	:	US
Telephone Number	:	619-723-7638
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EVERETT SIMERSON
Credential	:
Telephone Number	:	619-723-7638

Provider Enumeration Date	:	11/04/2020
Last Update Date	:	01/24/2022

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