MEDICARE: OMNI HOME HEALTH DISTRICT 4, LLC

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	251E00000X	Home Health Agency	299991765	FL

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

General Provider Information

NPI Number	:	1720060601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNI HOME HEALTH DISTRICT 4, LLC

Provider Business Mailing Address
First Line	:	510 HOSPITAL DR
Second Line	:	SUITE 150
City	:	MADISON
State	:	TN
Zip	:	37115-5033
Country	:	US
Telephone Number	:	615-712-2250
Fax Number	:	615-577-0081

Provider Business Practice Location Address
First Line	:	2651 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4519
Country	:	US
Telephone Number	:	904-389-7385
Fax Number	:	904-389-7359

Authorized Official
Title or Position	:	DIRECTOR OF LICENSING & ACCREDITATI
Name	:	AMANDA MCFADDIN
Credential	:
Telephone Number	:	615-712-2250

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	06/07/2012

Similar Medicare Providers

1437245990 — CONSOLIDATED PHARMACY SERVICES, INC
Practice Location Address:

2651 PARK STREET
JACKSONVILLE, FL
32204-4519

Practice Phone: 904-387-2448
Practice Fax: 904-387-0153

1619958352 — RETINA ASSOCIATES PA
Practice Location Address:

751 OAK ST STE 300
JACKSONVILLE, FL
32204-3376

Practice Phone: 904-388-8446
Practice Fax: 904-384-6261

1407728082 — SHERLEY SYLVAIN DNP, FNP-BC, FNP-C
Practice Location Address:

915 W MONROE ST STE 200
JACKSONVILLE, FL
32204-1177

Practice Phone: 904-384-2240
Practice Fax:

1952653180 — CYNTHIA CARANTA APRN, ACNP-BC
Practice Location Address:

915 W MONROE ST STE 200
JACKSONVILLE, FL
32204-1177

Practice Phone: 904-384-2240
Practice Fax:

1750115887 — ALEXANDRA MARIE SPENCE APRN
Practice Location Address:

915 W MONROE ST STE 200
JACKSONVILLE, FL
32204-1177

Practice Phone: 904-384-2240
Practice Fax: 904-486-2314

1386695302 — PHARMACY4HUMANITY
Practice Location Address:

2 SHIRCLIFF WAY STE 900
JACKSONVILLE, FL
32204-4753

Practice Phone: 904-389-9744
Practice Fax: 904-389-9406

Directions to “OMNI HOME HEALTH DISTRICT 4, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.