Healthcare Provider Details

I. General information

NPI: 1154748465
Provider Name (Legal Business Name): OMNIA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 BULLARD AVE
CLOVIS CA
93612-0902
US

IV. Provider business mailing address

105 BULLARD AVE
CLOVIS CA
93612-0902
US

V. Phone/Fax

Practice location:
  • Phone: 559-761-9656
  • Fax:
Mailing address:
  • Phone: 559-772-4673
  • Fax: 559-862-4675

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: ESTRELLA SARABOSING
Title or Position: PRESIDENT
Credential:
Phone: 559-761-9656