Healthcare Provider Details

I. General information

NPI: 1477496131
Provider Name (Legal Business Name): OMEGA MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 24TH ST LOWR LEVEL1E4
OGDEN UT
84401-2580
US

IV. Provider business mailing address

707 24TH ST LOWR LEVEL1-E
OGDEN UT
84401-2580
US

V. Phone/Fax

Practice location:
  • Phone: 866-631-3490
  • Fax: 866-631-3490
Mailing address:
  • Phone: 866-631-3490
  • Fax: 866-631-3490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NAEEM S EMMANUAL
Title or Position: OWNER
Credential: EMMANUAL
Phone: 866-631-3490