Healthcare Provider Details

I. General information

NPI: 1568771657
Provider Name (Legal Business Name): OMEGA ACCESS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 THISTEL DELL CT
OWINGS MILLS MD
21117-4526
US

IV. Provider business mailing address

2 THISTEL DELL CT
OWINGS MILLS MD
21117-4526
US

V. Phone/Fax

Practice location:
  • Phone: 443-742-6253
  • Fax: 410-741-3347
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number3144
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ILIONELE EMMANUEL OKOJIE
Title or Position: DIRECTOR/CEO
Credential: BSC MSC MBA TRANSPOR
Phone: 443-742-6253