Healthcare Provider Details

I. General information

NPI: 1376556522
Provider Name (Legal Business Name): SIM USA, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14830 CHOATE CIRCLE
CHARLOTTE NC
28273
US

IV. Provider business mailing address

PO BOX 7900
CHARLOTTE NC
28241-7900
US

V. Phone/Fax

Practice location:
  • Phone: 704-587-1415
  • Fax: 704-587-1554
Mailing address:
  • Phone: 704-587-1415
  • Fax: 704-587-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberNC19168
License Number StateNC

VIII. Authorized Official

Name: MR. HAROLD PAGAN HOPE JR.
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 704-587-1415