Healthcare Provider Details

I. General information

NPI: 1467920017
Provider Name (Legal Business Name): OMRO NURSING AND REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GRANT AVE
OMRO WI
54963-1342
US

IV. Provider business mailing address

8170 MCCORMICK BLVD STE 112
SKOKIE IL
60076-2914
US

V. Phone/Fax

Practice location:
  • Phone: 920-685-2755
  • Fax:
Mailing address:
  • Phone: 773-825-3336
  • Fax: 773-570-4554

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: PAMELA RICE
Title or Position: DIRECTOR OF REVENUE
Credential:
Phone: 847-712-8901