Provider Demographics
NPI:1275525404
Name:ACCESS HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:ACCESS HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:417-863-7100
Mailing Address - Street 1:2828 N NATIONAL AVE
Mailing Address - Street 2:SUITE I & J
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-4306
Mailing Address - Country:US
Mailing Address - Phone:417-863-7100
Mailing Address - Fax:417-863-7204
Practice Address - Street 1:1315 E MONTCLAIR ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4244
Practice Address - Country:US
Practice Address - Phone:417-863-7100
Practice Address - Fax:417-863-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO267502251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0003196Medicaid
MO0003196Medicaid