MEDICARE: OMNICARE HEALTH CENTERS, 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1437101672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNICARE HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	5068 W PLANO PKWY
Second Line	:	SUITE 224
City	:	PLANO
State	:	TX
Zip	:	75093-4408
Country	:	US
Telephone Number	:	972-447-0220
Fax Number	:

Provider Business Practice Location Address
First Line	:	5068 W PLANO PKWY
Second Line	:	SUITE 224
City	:	PLANO
State	:	TX
Zip	:	75093-4408
Country	:	US
Telephone Number	:	972-447-0220
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	DR. RUSSELL R SMITH
Credential	:	MD
Telephone Number	:	972-447-0220

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/22/2020

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