Provider Demographics
NPI:1356427082
Name:ACCESSHOME HEALTHCARE INC
Entity type:Organization
Organization Name:ACCESSHOME HEALTHCARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELECHI
Authorized Official - Middle Name:OLUCHI
Authorized Official - Last Name:IWUJI
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:919-264-6848
Mailing Address - Street 1:PO BOX 690631
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7011
Mailing Address - Country:US
Mailing Address - Phone:980-219-7468
Mailing Address - Fax:980-218-7469
Practice Address - Street 1:6101 IDLEWILD RD
Practice Address - Street 2:324
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-0517
Practice Address - Country:US
Practice Address - Phone:980-219-7468
Practice Address - Fax:980-219-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4106251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6602058Medicaid
NC3418204Medicaid