Provider Demographics
NPI:1043776883
Name:OMNI STAFFING SERVICES INC
Entity Type:Organization
Organization Name:OMNI STAFFING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CORBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:509-855-5497
Mailing Address - Street 1:1530 PILGRIM ST
Mailing Address - Street 2:
Mailing Address - City:MOSES LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98837-4623
Mailing Address - Country:US
Mailing Address - Phone:509-855-5497
Mailing Address - Fax:509-639-7063
Practice Address - Street 1:1530 PILGRIM ST
Practice Address - Street 2:
Practice Address - City:MOSES LAKE
Practice Address - State:WA
Practice Address - Zip Code:98837-4623
Practice Address - Country:US
Practice Address - Phone:509-855-5497
Practice Address - Fax:509-639-7063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty