Provider Demographics
NPI:1558855742
Name:ACCESS PRIMARY CARE
Entity Type:Organization
Organization Name:ACCESS PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIIULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-202-7723
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-0076
Mailing Address - Country:US
Mailing Address - Phone:614-746-3206
Mailing Address - Fax:614-859-1242
Practice Address - Street 1:1797 HILL RD N STE 101B
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7996
Practice Address - Country:US
Practice Address - Phone:614-746-3206
Practice Address - Fax:614-859-1242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty