| Omni Community Health | |
|
1407 Union Ave Suite 815 Memphis TN 38104-3679 | |
| (901) 800-4645 | |
| (901) 729-6377 |
| Full Name | Omni Community Health |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1407 Union Ave, Memphis, Tennessee |
| Authorized Official Name and Position | Mark Just (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6157263603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omni Community Health 301 S Perimeter Park Drive Suite 210 Nashville TN 37211-4128 Ph: (615) 726-3603 | Omni Community Health 1407 Union Ave Suite 815 Memphis TN 38104-3679 Ph: (901) 800-4645 |
| NPI Number | 1316320880 |
|---|---|
| Provider Enumeration Date | 07/02/2015 |
| Last Update Date | 09/02/2020 |
| Certification Date | 09/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316320880 | NPI | - | NPPES |
| 3376955 | Medicaid | TN | |
| Q019918 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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