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NPI Code Detail

MEDICARE: OMEGA HEALTH CARE OF NORTHWEST MISSOURI, INC.

MEDICARE: OMEGA HEALTH CARE OF NORTHWEST MISSOURI, 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
1251G00000XCommunity Based Hospice Care Agency00919007MO

General Provider Information

NPI Number : 1609028547
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMEGA HEALTH CARE OF NORTHWEST MISSOURI, INC.
Provider Business Mailing Address
First Line : 3171 NE CARNEGIE DR
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64064-3215
Country : US
Telephone Number : 816-268-4130
Fax Number :
Provider Business Practice Location Address
First Line : 3171 NE CARNEGIE DR
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64064-3215
Country : US
Telephone Number : 816-268-4130
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. RUSS L ROGERS
Credential :
Telephone Number : 913-814-7105
Provider Enumeration Date : 10/22/2008
Last Update Date : 12/02/2008

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