Healthcare Provider Details

I. General information

NPI: 1487922522
Provider Name (Legal Business Name): SYSTEMS INTEGRATION MODELING & SIMULATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2011
Last Update Date: 12/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SW ATLANTIC ST
TULLAHOMA TN
37388-4409
US

IV. Provider business mailing address

400 SW ATLANTIC ST
TULLAHOMA TN
37388-4409
US

V. Phone/Fax

Practice location:
  • Phone: 931-461-8800
  • Fax: 931-455-0834
Mailing address:
  • Phone: 931-461-8800
  • Fax: 931-455-0834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: MR. EUGENE RUSSELL LONDON JR.
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 931-461-8800