MEDICARE: OMNIBUS HEALTH AND HUMAN 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1518213651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNIBUS HEALTH AND HUMAN SERVICES, INC.

Provider Business Mailing Address
First Line	:	3860 SHERIDAN ST STE A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3624
Country	:	US
Telephone Number	:	954-401-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	3860 SHERIDAN ST STE A
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-3624
Country	:	US
Telephone Number	:	954-401-5214
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SHARMA S ELDRIDGE
Credential	:	RN, CMC
Telephone Number	:	954-401-5214

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	07/26/2012

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