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General NPI Number Information
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NPI Number | 1902402894
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Entity Type | Organization
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Legal Business Name | OMNIACARE LLC
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Dates
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Enumeration Date | 12/07/2020
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 350 FALCON RIDGE PKWY STE 101
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City | MESQUITE
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State | NV
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Zip | 89027-8879
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Country | US
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Telephone | 702-849-0585
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Fax | 702-849-0614
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Provider Business Mailing Address
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Address Line | 1977 E 2590 SOUTH CIR
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City | ST GEORGE
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State | UT
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Zip | 84790-7024
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Country | US
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Telephone | 435-467-8201
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Fax |
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Authorized Official
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Title or Position | PART OWNER
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Name | VANESSA DAWN BARBEN
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Credential | RN
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Telephone | 435-467-8201
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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 |
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