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General NPI Number Information
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NPI Number | 1376775676
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Entity Type | Organization
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Legal Business Name | OMEGA HEALTH CARE OF GEORGIA INC
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 08/20/2009
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Provider Practice Location Address
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Address Line | 1201 PEACHTREE ST NE SUITE 1240
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City | ATLANTA
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State | GA
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Zip | 30361-6302
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Country | US
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Telephone | 816-268-4130
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Fax |
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Provider Business Mailing Address
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Address Line | 3171 NE CARNEGIE DR
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City | LEES SUMMIT
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State | MO
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Zip | 64064-3215
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Country | US
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Telephone | 816-268-4130
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RUSS ROGERS
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Credential |
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Telephone | 913-708-5391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | GA
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