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General NPI Number Information
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NPI Number | 1962026831
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Entity Type | Organization
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Legal Business Name | OMEGA STRATEGIC CONSULTING
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Dates
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Enumeration Date | 06/05/2020
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 23619 N 169TH AVE
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City | SURPRISE
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State | AZ
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Zip | 85387-2060
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Country | US
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Telephone | 210-382-0138
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Fax |
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Provider Business Mailing Address
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Address Line | 23619 N 169TH AVE
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City | SURPRISE
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State | AZ
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Zip | 85387-2060
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Country | US
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Telephone | 210-382-0138
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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. BRIAN DAVID BENAVIDES
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Credential |
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Telephone | 210-382-0138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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