Healthcare Provider Details

I. General information

NPI: 1073516894
Provider Name (Legal Business Name): HEALTHACCESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 W H SMITH BLVD
GREENVILLE NC
27834-5052
US

IV. Provider business mailing address

PO BOX 8125
GREENVILLE NC
27835-8125
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-7830
  • Fax: 252-847-7910
Mailing address:
  • Phone: 252-847-7830
  • Fax: 252-847-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHOS0425
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHOS1711
License Number StateNC

VIII. Authorized Official

Name: MR. RYAN TODD HICKEY
Title or Position: PRESIDENT
Credential:
Phone: 252-847-7836