=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164173183
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABROMA HEALTH SYSTEMS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2022
-----------------------------------------------------
Last Update Date | 01/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2102 MAIN ST
-----------------------------------------------------
City | RAMONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92065-2519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-500-5213
-----------------------------------------------------
Fax | 858-500-5212
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20040 SUNSET OAKS DR
-----------------------------------------------------
City | RAMONA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92065-6103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 858-500-5213
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF NURSING
-----------------------------------------------------
Name | MR. EMMANUEL ASIEDU ABROKWA
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 858-500-5213
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251F00000X
-----------------------------------------------------
Taxonomy Name | Home Infusion Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------