Provider Demographics
NPI:1568521961
Name:ACCESSCARE
Entity Type:Organization
Organization Name:ACCESSCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF CLINICAL AFFAIRS
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCELLETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:919-380-9962
Mailing Address - Street 1:3000 AERIAL CENTER PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-9132
Mailing Address - Country:US
Mailing Address - Phone:919-380-9962
Mailing Address - Fax:919-468-8573
Practice Address - Street 1:3000 AERIAL CENTER PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9132
Practice Address - Country:US
Practice Address - Phone:919-380-9962
Practice Address - Fax:919-468-8573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418161Medicaid
NC6701006OtherCCNC NETWORK #