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NPI Code Detail

MEDICARE: OMRO HEALTHCARE LLC

MEDICARE: OMRO HEALTHCARE 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
1314000000XSkilled Nursing Facility3241WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912944810
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMRO HEALTHCARE LLC
Provider Business Mailing Address
First Line : 500 GRANT AVE
Second Line :
City : OMRO
State : WI
Zip : 54963-1342
Country : US
Telephone Number : 920-685-2755
Fax Number : 920-685-0599
Provider Business Practice Location Address
First Line : 500 GRANT AVE
Second Line :
City : OMRO
State : WI
Zip : 54963-1342
Country : US
Telephone Number : 920-685-2755
Fax Number : 920-685-0599
Authorized Official
Title or Position : MANAGER
Name : WILLIAM R. WATSON II
Credential :
Telephone Number : 920-685-2755
Provider Enumeration Date : 05/31/2006
Last Update Date : 09/29/2016

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Directions to “OMRO HEALTHCARE LLC ” Practice Location

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