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General NPI Number Information
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NPI Number | 1144396391
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Entity Type | Organization
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Legal Business Name | PRIVATELY YOURS BY OMA
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 1943 ROUTE 14 N
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City | GENEVA
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State | NY
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Zip | 14456
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Country | US
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Telephone | 315-789-2354
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Fax |
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Provider Business Mailing Address
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Address Line | 2413 CARTER RD
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City | GENEVA
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State | NY
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Zip | 14456
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Country | US
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Telephone | 315-789-2354
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | OMA P WILSON
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Credential |
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Telephone | 315-789-2354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | NO LISCENSE REQUIRED
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License Number State |
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