Provider Demographics
NPI:1376775676
Name:OMEGA HEALTH CARE OF GEORGIA INC
Entity Type:Organization
Organization Name:OMEGA HEALTH CARE OF GEORGIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-708-5391
Mailing Address - Street 1:3171 NE CARNEGIE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-3215
Mailing Address - Country:US
Mailing Address - Phone:816-268-4130
Mailing Address - Fax:
Practice Address - Street 1:1201 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1240
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30361-6302
Practice Address - Country:US
Practice Address - Phone:816-268-4130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based