Provider Demographics
NPI:1699102764
Name:SIMON, BARBARA A
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:SIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 CHADFORD RD
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-2158
Mailing Address - Country:US
Mailing Address - Phone:803-556-2968
Mailing Address - Fax:
Practice Address - Street 1:931 CHADFORD RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-2158
Practice Address - Country:US
Practice Address - Phone:803-556-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health