MEDICARE: OZIK ADULT HEALTHCARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	00010747	MO

General Provider Information

NPI Number	:	1164413993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZIK ADULT HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	5081 PAGE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1601
Country	:	US
Telephone Number	:	314-454-1219
Fax Number	:	314-454-1382

Provider Business Practice Location Address
First Line	:	5081 PAGE BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63113-1601
Country	:	US
Telephone Number	:	314-454-1219
Fax Number	:	314-454-1382

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MR. ISAAC N ONYEMA
Credential	:	MBA
Telephone Number	:	314-454-1219

Provider Enumeration Date	:	11/01/2005
Last Update Date	:	08/22/2020

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