| Om Healthcare Llc | |
|
125 E Broad St Ste 215 Elyria OH 44035 | |
| (440) 329-7305 | |
| (440) 329-7798 |
| Full Name | Om Healthcare Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 125 E Broad St, Elyria, Ohio |
| Authorized Official Name and Position | Kathy Darlene Becker (OFFICE MANAGER) |
| Authorized Official Contact | 4403264355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Om Healthcare Llc 125 E Broad St Ste 202 Elyria OH 44035 Ph: (440) 329-7305 | Om Healthcare Llc 125 E Broad St Ste 215 Elyria OH 44035 Ph: (440) 329-7305 |
| NPI Number | 1205838067 |
|---|---|
| Provider Enumeration Date | 08/11/2005 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205838067 | NPI | - | NPPES |
| 09328932 | Other | OH | MEDICARE STE 215 |
| 2348963 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Ohio) | Primary |
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