Provider Demographics
NPI:1164413993
Name:OZIK ADULT HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:OZIK ADULT HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:N
Authorized Official - Last Name:ONYEMA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:314-454-1219
Mailing Address - Street 1:5081 PAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63113-1601
Mailing Address - Country:US
Mailing Address - Phone:314-454-1219
Mailing Address - Fax:314-454-1382
Practice Address - Street 1:5081 PAGE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113-1601
Practice Address - Country:US
Practice Address - Phone:314-454-1219
Practice Address - Fax:314-454-1382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00010747251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO267596Medicare ID - Type Unspecified