Healthcare Provider Details

I. General information

NPI: 1790868339
Provider Name (Legal Business Name): ACCESS HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 GRAVES MILL RD
FOREST VA
24551-2675
US

IV. Provider business mailing address

2103 GRAVES MILL RD
FOREST VA
24551-2675
US

V. Phone/Fax

Practice location:
  • Phone: 434-316-7199
  • Fax: 434-316-6185
Mailing address:
  • Phone: 434-316-7199
  • Fax: 434-316-6185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA SHELOR
Title or Position: OFFICE MANAGER
Credential:
Phone: 434-316-7199