1275583676 NPI number — ACCESS TO CARE, LLC

Table of content: (NPI 1275583676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275583676 NPI number — ACCESS TO CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESS TO CARE, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275583676
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3645 N BRIARWOOD LN STE D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MUNCIE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47304-5337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-720-3900
Provider Business Mailing Address Fax Number:
765-282-4588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3645 N BRIARWOOD LN
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
MUNCIE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47304-5337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-282-4766
Provider Business Practice Location Address Fax Number:
765-282-4588
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
E
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
336-688-4909

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 60005854A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200255780A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200255780 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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