Healthcare Provider Details

I. General information

NPI: 1487180030
Provider Name (Legal Business Name): OM HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2017
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MCMURTRIE DR NW STE D4
HUNTSVILLE AL
35806-2470
US

IV. Provider business mailing address

1101 MCMURTRIE DR NW STE D4
HUNTSVILLE AL
35806-2470
US

V. Phone/Fax

Practice location:
  • Phone: 256-801-3600
  • Fax: 256-801-3602
Mailing address:
  • Phone: 256-801-3600
  • Fax: 256-801-3602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SOURABH CHATTERJEE
Title or Position: CEO
Credential:
Phone: 256-801-3600