Provider Demographics
NPI:1083023659
Name:OPTIMUS HOMECARE LLC
Entity type:Organization
Organization Name:OPTIMUS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:ELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:201-360-1240
Mailing Address - Street 1:24 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2224
Mailing Address - Country:US
Mailing Address - Phone:201-360-1240
Mailing Address - Fax:
Practice Address - Street 1:24 SYCAMORE RD
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2224
Practice Address - Country:US
Practice Address - Phone:201-360-1240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care