| Oms Primary Care Inc | |
|
2145 Roswell Rd Ste 60 Marietta GA 30062-0819 | |
| (770) 672-6267 | |
| (770) 485-8665 |
| Full Name | Oms Primary Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2145 Roswell Rd Ste 60, Marietta, Georgia |
| Authorized Official Name and Position | Omokhuale Omokhodion (OWNER) |
| Authorized Official Contact | 7706726267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oms Primary Care Inc 2145 Roswell Rd Ste 60 Marietta GA 30062-0819 Ph: (770) 672-6267 | Oms Primary Care Inc 2145 Roswell Rd Ste 60 Marietta GA 30062-0819 Ph: (770) 672-6267 |
| NPI Number | 1063123933 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/12/2022 |
| Medicare PECOS PAC ID | 6103297932 |
|---|---|
| Medicare Enrollment ID | O20230113001474 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063123933 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Omokhuale Omokhodion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861620981 PECOS PAC ID: 6608916424 Enrollment ID: I20150527001375 |
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