Healthcare Provider Details

I. General information

NPI: 1043920192
Provider Name (Legal Business Name): OMICELO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 BEDFORD AVENUE
PITTSBURGH PA
15219-3675
US

IV. Provider business mailing address

1435 BEDFORD AVENUE
PITTSBURGH PA
15219-3675
US

V. Phone/Fax

Practice location:
  • Phone: 412-212-6870
  • Fax: 412-202-2029
Mailing address:
  • Phone: 412-212-6870
  • Fax: 412-202-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSHUA POLLARD
Title or Position: CEO
Credential:
Phone: 412-212-6870