Healthcare Provider Details

I. General information

NPI: 1316432016
Provider Name (Legal Business Name): ACCESSIBLE SOLUTIONS BROKERAGE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/01/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 ERIN CT STE A
LANCASTER PA
17601-1965
US

IV. Provider business mailing address

2270 ERIN CT STE A
LANCASTER PA
17601-1965
US

V. Phone/Fax

Practice location:
  • Phone: 717-397-1841
  • Fax: 717-947-7446
Mailing address:
  • Phone: 717-397-1841
  • Fax: 717-947-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberPA009758
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberPA009758
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MASON SMELTZER
Title or Position: DIRECTOR
Credential:
Phone: 717-397-1841