Provider Demographics
NPI:1619585494
Name:EASYACCESS HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:EASYACCESS HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAKULOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-282-0227
Mailing Address - Street 1:3957 ABBIE COVE LN
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-7536
Mailing Address - Country:US
Mailing Address - Phone:614-282-0227
Mailing Address - Fax:
Practice Address - Street 1:3957 ABBIE COVE LN
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-7536
Practice Address - Country:US
Practice Address - Phone:614-282-0227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHTM022973OtherDRIVER'S LICENSE