Organization Name: | OMEGA MEDICAL SUPPLY, LLC |
NPI Number: | 1740537331 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ADERONKE OLANREWAJU MORDI (PRESIDENT AND CEO) |
Mailing Address: | 125 West Main St New Prague |
State: | MN US |
Postal Code: | 56071 |
Phone Number: | 5072528413 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2012 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 7134684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |