Healthcare Provider Details

I. General information

NPI: 1659998557
Provider Name (Legal Business Name): OM HARI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BUSINESS PKWY # A-C
PIEDMONT SC
29673-6707
US

IV. Provider business mailing address

100 BUSINESS PKWY # A-C
PIEDMONT SC
29673-6707
US

V. Phone/Fax

Practice location:
  • Phone: 908-616-3569
  • Fax:
Mailing address:
  • Phone: 908-616-3569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIJESH PATEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 848-209-6868