Provider Demographics
NPI:1366012700
Name:ACCESS ONE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ACCESS ONE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELONIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-498-2776
Mailing Address - Street 1:8123 DELMAR BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3729
Mailing Address - Country:US
Mailing Address - Phone:314-498-2776
Mailing Address - Fax:
Practice Address - Street 1:8123 DELMAR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-3729
Practice Address - Country:US
Practice Address - Phone:314-498-2776
Practice Address - Fax:314-558-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1902481955Medicaid