Healthcare Provider Details

I. General information

NPI: 1407099229
Provider Name (Legal Business Name): CNC / ACCESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 COUNTRY HOME ROAD
SHELBY NC
28152
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-5186
US

V. Phone/Fax

Practice location:
  • Phone: 502-394-2100
  • Fax:
Mailing address:
  • Phone: 800-866-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET SHERRY PEMBERTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-272-3466