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General NPI Number Information
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NPI Number | 1790736478
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Entity Type | Organization
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Legal Business Name | OMNICARE HOME HEALTH INC.
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 550 E. BOUGHTON RD. SUITE 130
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2192
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Country | US
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Telephone | 630-972-0668
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Fax | 630-972-0669
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Provider Business Mailing Address
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Address Line | 550 E. BOUGHTON RD. SUITE 130
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City | BOLINGBROOK
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State | IL
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Zip | 60440-2192
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Country | US
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Telephone | 630-972-0668
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Fax | 630-972-0669
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LIBERTY ANONUEVO
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Credential | REGISTERED NURSE
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Telephone | 630-972-0668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010554
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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