| Omnis Health Life, Llc | |
|
2200 Garrison Blvd Baltimore MD 21216-2619 | |
| (667) 212-4187 | |
| Not Available |
| Full Name | Omnis Health Life, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2200 Garrison Blvd, Baltimore, Maryland |
| Authorized Official Name and Position | Rachel Wilson (CHAIRWOMAN) |
| Authorized Official Contact | 6785613037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omnis Health Life, Llc 162 Ponte Vedra Dr Fayetteville GA 30215-8040 Ph: (678) 561-2823 | Omnis Health Life, Llc 2200 Garrison Blvd Baltimore MD 21216-2619 Ph: (667) 212-4187 |
| NPI Number | 1154861557 |
|---|---|
| Provider Enumeration Date | 03/03/2017 |
| Last Update Date | 11/15/2018 |
| Medicare PECOS PAC ID | 5395083778 |
|---|---|
| Medicare Enrollment ID | O20190211000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154861557 | NPI | - | NPPES |
| Provider Name | Sarah A Merritt |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1730303777 PECOS PAC ID: 0143380204 Enrollment ID: I20081119000190 |
| Provider Name | Nicholas Gerardo Scotto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760507925 PECOS PAC ID: 9537294392 Enrollment ID: I20100507000680 |
| Provider Name | Joseph A Adams |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1578637294 PECOS PAC ID: 5395984777 Enrollment ID: I20130614000437 |
| Provider Name | Angela Awuah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417351255 PECOS PAC ID: 4789902867 Enrollment ID: I20150422000238 |
| Provider Name | Matilda Korkor Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043721343 PECOS PAC ID: 7214275833 Enrollment ID: I20190206002147 |
| Provider Name | Sylvianne Akum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336768787 PECOS PAC ID: 1456770478 Enrollment ID: I20200924001722 |
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