MEDICARE: OVATIONS HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861097230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVATIONS HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	3000 JOE DIMAGGIO BLVD STE 9
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3989
Country	:	US
Telephone Number	:	512-771-6193
Fax Number	:	512-692-9142

Provider Business Practice Location Address
First Line	:	3000 JOE DIMAGGIO BLVD STE 9
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3989
Country	:	US
Telephone Number	:	512-771-6193
Fax Number	:	512-692-9142

Authorized Official
Title or Position	:	PRESIDENT/CEO OR ADMINISTRATOR
Name	:	OJ DOUGLAS IGWE SR.
Credential	:
Telephone Number	:	512-771-6193

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	12/02/2020

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