MEDICARE: ACCESSHOME HEALTHCARE 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	HC4106	NC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356427082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESSHOME HEALTHCARE INC

Provider Business Mailing Address
First Line	:	PO BOX 690631
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28227-7011
Country	:	US
Telephone Number	:	980-219-7468
Fax Number	:	980-218-7469

Provider Business Practice Location Address
First Line	:	6101 IDLEWILD RD
Second Line	:	324
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-0517
Country	:	US
Telephone Number	:	980-219-7468
Fax Number	:	980-219-7469

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	MRS. KELECHI OLUCHI IWUJI SR.
Credential	:
Telephone Number	:	919-264-6848

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	10/08/2013

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