Healthcare Provider Details

I. General information

NPI: 1376330597
Provider Name (Legal Business Name): OMCI OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 E 28TH ST
TULSA OK
74114-5915
US

IV. Provider business mailing address

3333 E 28TH ST
TULSA OK
74114-5915
US

V. Phone/Fax

Practice location:
  • Phone: 918-203-0606
  • Fax:
Mailing address:
  • Phone: 918-203-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DAVID GANZ
Title or Position: LLC MANAGER
Credential:
Phone: 832-422-8848