MEDICARE: ACCESS HOME CARE II

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	7514	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7514	OTHER	OK	HOME HEALTH LICENSE

General Provider Information

NPI Number	:	1063473825
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS HOME CARE II

Provider Business Mailing Address
First Line	:	200 W GENTRY AVE
Second Line	:
City	:	CHECOTAH
State	:	OK
Zip	:	74426-2440
Country	:	US
Telephone Number	:	918-473-1851
Fax Number	:	918-473-1808

Provider Business Practice Location Address
First Line	:	200 W GENTRY AVE
Second Line	:
City	:	CHECOTAH
State	:	OK
Zip	:	74426-2440
Country	:	US
Telephone Number	:	918-473-1851
Fax Number	:	918-473-1808

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. CHRISTIE GRIFFIN
Credential	:	RN
Telephone Number	:	918-473-1851

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	08/22/2020

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Directions to “ACCESS HOME CARE II ” Practice Location

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