Provider Demographics
NPI:1144339839
Name:SIMPSON COMMUNITY HEALTHCARE, INC.
Entity type:Organization
Organization Name:SIMPSON COMMUNITY HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEDGEWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-847-7214
Mailing Address - Street 1:1842 SIMPSON HIGHWAY 149
Mailing Address - Street 2:
Mailing Address - City:MENDENHALL
Mailing Address - State:MS
Mailing Address - Zip Code:39114-3438
Mailing Address - Country:US
Mailing Address - Phone:601-847-2221
Mailing Address - Fax:601-847-7104
Practice Address - Street 1:1842 SIMPSON HIGHWAY 149
Practice Address - Street 2:
Practice Address - City:MENDENHALL
Practice Address - State:MS
Practice Address - Zip Code:39114-3438
Practice Address - Country:US
Practice Address - Phone:601-847-2221
Practice Address - Fax:601-847-7104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11216282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS19240AOtherBLUE CROSS
MS0020167Medicaid
MS000019240OtherBLUECROSS DR
MS000020840OtherBLUE CROSS
MS081261708Medicare PIN
MS930001140Medicare PIN
MS000019240OtherBLUECROSS DR
MS000020840OtherBLUE CROSS
MS930001483Medicare PIN
MS930002877Medicare UPIN
MS251317Medicare Oscar/Certification
MS081261707Medicare PIN