=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568521961
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCESSCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/08/2006
-----------------------------------------------------
Last Update Date | 02/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3000 AERIAL CENTER PKWY SUITE 101
-----------------------------------------------------
City | MORRISVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27560-9132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-380-9962
-----------------------------------------------------
Fax | 919-468-8573
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3000 AERIAL CENTER PKWY SUITE 101
-----------------------------------------------------
City | MORRISVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27560-9132
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-380-9962
-----------------------------------------------------
Fax | 919-468-8573
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT OF CLINICAL AFFAIRS
-----------------------------------------------------
Name | MS. MARCELLETTA MILES
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 919-380-9962
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------