Provider Demographics
NPI:1619439049
Name:ACCESS MEDICAL HEALTH PLAN CORP LLC
Entity Type:Organization
Organization Name:ACCESS MEDICAL HEALTH PLAN CORP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:INWANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:850-222-1963
Mailing Address - Street 1:175 SALEM CT
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2809
Mailing Address - Country:US
Mailing Address - Phone:850-222-1963
Mailing Address - Fax:
Practice Address - Street 1:175 SALEM CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2809
Practice Address - Country:US
Practice Address - Phone:850-222-1963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty