MEDICARE: ACCESICARE, LLC

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	253Z00000X	In Home Supportive Care Agency	13-012880-1	IN

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	:	1356777254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESICARE, LLC

Provider Business Mailing Address
First Line	:	7780 COOKS MILL RD
Second Line	:
City	:	GEORGETOWN
State	:	IN
Zip	:	47122-9524
Country	:	US
Telephone Number	:	812-725-3708
Fax Number	:

Provider Business Practice Location Address
First Line	:	757 HIGHLANDER POINT DR
Second Line	:
City	:	FLOYDS KNOBS
State	:	IN
Zip	:	47119-9682
Country	:	US
Telephone Number	:	812-725-3708
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MRS. DEBRA JEAN BAKER
Credential	:	RN
Telephone Number	:	812-725-3843

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	09/24/2013

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Directions to “ACCESICARE, LLC ” Practice Location

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