Healthcare Provider Details

I. General information

NPI: 1124064514
Provider Name (Legal Business Name): ACCESS HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NEW MARKET PKWY SE SUITE 156
MARIETTA GA
30067-9399
US

IV. Provider business mailing address

2211 NEW MARKET PKWY SE SUITE 156
MARIETTA GA
30067-9399
US

V. Phone/Fax

Practice location:
  • Phone: 678-391-6900
  • Fax: 678-391-6907
Mailing address:
  • Phone: 678-391-6900
  • Fax: 678-391-6907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD JERE DOZIER
Title or Position: CEO
Credential:
Phone: 678-391-6900