MEDICARE: OBYKE HEALTHCARE SERVICES

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	302R00000X	Health Maintenance Organization	6961	LA

General Provider Information

NPI Number	:	1659812527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OBYKE HEALTHCARE SERVICES

Provider Business Mailing Address
First Line	:	3028 GENTILLY BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-3808
Country	:	US
Telephone Number	:	504-948-6080
Fax Number	:	504-948-6089

Provider Business Practice Location Address
First Line	:	3028 GENTILLY BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-3808
Country	:	US
Telephone Number	:	504-948-6080
Fax Number	:	504-948-6089

Authorized Official
Title or Position	:	CEO
Name	:	ROSE OKPALOBI
Credential	:
Telephone Number	:	504-948-6080

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	03/13/2017

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Directions to “OBYKE HEALTHCARE SERVICES ” Practice Location

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