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General NPI Number Information
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NPI Number | 1780989970
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Entity Type | Organization
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Legal Business Name | OMEGA DME, LLC
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 01/19/2011
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Provider Practice Location Address
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Address Line | 21977 MIKHAIL ST
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City | SANTA CLARITA
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State | CA
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Zip | 91390-5720
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Country | US
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Telephone | 818-748-9600
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Fax | 818-746-9601
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Provider Business Mailing Address
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Address Line | 18533 ROSCOE BLVD #159
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4632
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Country | US
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Telephone | 818-748-9600
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Fax | 818-746-9601
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MR. JEFF L SIMS
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Credential |
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Telephone | 818-745-5583
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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 |
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License Number State | CA
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