MEDICARE: OMNI HOME CARE AGENCY LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1518566322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI HOME CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	8008 SPLITRAIL CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4488
Country	:	US
Telephone Number	:	214-686-4480
Fax Number	:

Provider Business Practice Location Address
First Line	:	8008 SPLITRAIL CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4488
Country	:	US
Telephone Number	:	214-686-4480
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMEH BEKHEET
Credential	:
Telephone Number	:	214-686-4480

Provider Enumeration Date	:	10/22/2020
Last Update Date	:	10/22/2020

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Directions to “OMNI HOME CARE AGENCY LLC ” Practice Location

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