Healthcare Provider Details

I. General information

NPI: 1275797391
Provider Name (Legal Business Name): MEDACCESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 07/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HARDAMAN CIR
BOONE NC
28607-8158
US

IV. Provider business mailing address

PO BOX 2775
BOONE NC
28607-2775
US

V. Phone/Fax

Practice location:
  • Phone: 828-264-4085
  • Fax:
Mailing address:
  • Phone: 828-264-4085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL K STOVER
Title or Position: CEO / PRESIDENT
Credential:
Phone: 828-264-4085