Provider Demographics
NPI:1588959225
Name:HEALTHACCESS, INC.
Entity type:Organization
Organization Name:HEALTHACCESS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOUGLASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-847-9168
Mailing Address - Street 1:PO BOX 8125
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-8125
Mailing Address - Country:US
Mailing Address - Phone:252-847-7830
Mailing Address - Fax:252-847-7910
Practice Address - Street 1:1211 HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3405
Practice Address - Country:US
Practice Address - Phone:252-975-8330
Practice Address - Fax:252-948-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WH0200X
NCHC1634251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3407250Medicaid
NC347250Medicare PIN
NC3407250Medicaid