MEDICARE: ACCESS HOME HEALTH AGENCY, INC.

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	267502	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275525404
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	2828 N NATIONAL AVE
Second Line	:	SUITE I & J
City	:	SPRINGFIELD
State	:	MO
Zip	:	65803-4306
Country	:	US
Telephone Number	:	417-863-7100
Fax Number	:	417-863-7204

Provider Business Practice Location Address
First Line	:	1315 E MONTCLAIR ST
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-4244
Country	:	US
Telephone Number	:	417-863-7100
Fax Number	:	417-863-7204

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MELANIE F MARKHAM
Credential	:	RN
Telephone Number	:	417-863-7100

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	01/16/2008

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