Provider Demographics
NPI:1063955268
Name:ACCESSCARE TELEHEALTH INC
Entity type:Organization
Organization Name:ACCESSCARE TELEHEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PERRENOD
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-C
Authorized Official - Phone:888-966-2398
Mailing Address - Street 1:200 S VIRGINIA ST
Mailing Address - Street 2:STE 800
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-2405
Mailing Address - Country:US
Mailing Address - Phone:888-966-2398
Mailing Address - Fax:888-966-2398
Practice Address - Street 1:200 S VIRGINIA ST
Practice Address - Street 2:STE 800
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2405
Practice Address - Country:US
Practice Address - Phone:888-966-2398
Practice Address - Fax:888-966-2398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV220965Medicare PIN