MEDICARE: OMNI HEALTH SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205591914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 454
Second Line	:
City	:	MONTGOMERYVILLE
State	:	PA
Zip	:	18936-0454
Country	:	US
Telephone Number	:	215-997-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6930 MARKET ST FL 2
Second Line	:
City	:	UPPER DARBY
State	:	PA
Zip	:	19082-2308
Country	:	US
Telephone Number	:	215-997-2000
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	JAN MONTGOMERY
Credential	:
Telephone Number	:	215-997-2000

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	12/05/2025

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Directions to “OMNI HEALTH SERVICES INC ” Practice Location

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