Provider Demographics
NPI:1417509472
Name:OMEGA HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:OMEGA HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ADERONKE
Authorized Official - Middle Name:OLANREWAJU
Authorized Official - Last Name:MORDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-951-4344
Mailing Address - Street 1:3900 FAIRWAY PL NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-5039
Mailing Address - Country:US
Mailing Address - Phone:888-995-4742
Mailing Address - Fax:507-252-1985
Practice Address - Street 1:1432 OLD WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2161
Practice Address - Country:US
Practice Address - Phone:888-995-4742
Practice Address - Fax:507-252-1985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health