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General NPI Number Information
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NPI Number | 1942715404
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Entity Type | Organization
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Legal Business Name | SIMPRA ADVANTAGE, INC.
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Dates
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Enumeration Date | 12/06/2017
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 3008 7TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-3503
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Country | US
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Telephone | 205-320-7575
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Fax | 205-320-7595
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Provider Business Mailing Address
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Address Line | 3008 7TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-3503
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Country | US
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Telephone | 205-320-7575
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Fax | 205-320-7595
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Authorized Official
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Title or Position | CEO
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Name | RONALD CHAFFIN
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Credential |
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Telephone | 205-320-7575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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