Provider Demographics
NPI:1215493473
Name:OMNI HEALTHCARE AND STAFFING AGENCY
Entity type:Organization
Organization Name:OMNI HEALTHCARE AND STAFFING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:CHRISTMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-882-1118
Mailing Address - Street 1:PO BOX 1381
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38663-1397
Mailing Address - Country:US
Mailing Address - Phone:662-882-1118
Mailing Address - Fax:662-837-7047
Practice Address - Street 1:1817 CITY AVE N
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-1153
Practice Address - Country:US
Practice Address - Phone:662-587-5070
Practice Address - Fax:662-837-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care