Provider Demographics
NPI:1336562321
Name:ACCESS ONE BY MSG INC.
Entity Type:Organization
Organization Name:ACCESS ONE BY MSG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GAWEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-485-7007
Mailing Address - Street 1:6652 SAINT JOE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46835-1974
Mailing Address - Country:US
Mailing Address - Phone:260-485-7007
Mailing Address - Fax:260-486-7887
Practice Address - Street 1:6652 SAINT JOE RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46835-1974
Practice Address - Country:US
Practice Address - Phone:260-485-7007
Practice Address - Fax:260-486-7887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN0132993023332B00000X, 332BC3200X, 332BD1200X, 332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN610371770OtherDUN & BRADSTREET
IN200802140Medicaid
IN200806100Medicaid
IN200806100Medicaid