Healthcare Provider Details

I. General information

NPI: 1629272000
Provider Name (Legal Business Name): SIMPSON COMMUNITY HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1842 SIMPSON HIGHWAY 149
MENDENHALL MS
39114-3438
US

IV. Provider business mailing address

1842 SIMPSON HIGHWAY 149
MENDENHALL MS
39114-3438
US

V. Phone/Fax

Practice location:
  • Phone: 601-847-7130
  • Fax: 601-847-7104
Mailing address:
  • Phone: 601-847-7130
  • Fax: 601-847-7104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHELLY G RILEY
Title or Position: CCO BUSINESS OFFICE DIRECTOR
Credential:
Phone: 601-847-7130