Provider Demographics
NPI:1063897569
Name:OPTIMUS HOMECARE
Entity type:Organization
Organization Name:OPTIMUS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, BBA
Authorized Official - Phone:201-360-1240
Mailing Address - Street 1:50 HARRISON ST STE 212J
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6087
Mailing Address - Country:US
Mailing Address - Phone:201-360-1240
Mailing Address - Fax:720-294-3788
Practice Address - Street 1:50 HARRISON ST STE 212J
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6087
Practice Address - Country:US
Practice Address - Phone:201-360-1240
Practice Address - Fax:720-294-3788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-25
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health