Healthcare Provider Details

I. General information

NPI: 1548537475
Provider Name (Legal Business Name): ACCENTS CONTRACTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 CHURCH RD
MOUNTAIN TOP PA
18707-2344
US

IV. Provider business mailing address

22 CHURCH RD
MOUNTAIN TOP PA
18707-2344
US

V. Phone/Fax

Practice location:
  • Phone: 570-266-9842
  • Fax: 570-474-9836
Mailing address:
  • Phone: 570-266-9842
  • Fax: 570-474-9836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberPA071901
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberPA071901
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH M PHILLIPS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 570-266-9842