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General NPI Number Information
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NPI Number | 1093907487
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Entity Type | Organization
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Legal Business Name | OMEGA CARE INC
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 111 LOHMANS LANE
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City | HELENA
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State | AR
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Zip | 72342-0394
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Country | US
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Telephone | 870-338-6330
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Fax | 870-338-6388
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Provider Business Mailing Address
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Address Line | PO BOX 394
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City | HELENA
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State | AR
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Zip | 72342-0394
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Country | US
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Telephone | 870-338-3289
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Fax | 870-338-6388
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Authorized Official
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Title or Position | OWNER
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Name | MR. SAMMY C BROCATO
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Credential |
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Telephone | 870-338-0545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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