Provider Demographics
NPI:1417612557
Name:OMNI GROUP INTERNATIONAL
Entity Type:Organization
Organization Name:OMNI GROUP INTERNATIONAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-540-3347
Mailing Address - Street 1:4818 ROSE CREEK PKWY S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-6843
Mailing Address - Country:US
Mailing Address - Phone:218-979-1377
Mailing Address - Fax:
Practice Address - Street 1:4818 ROSE CREEK PKWY S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-6843
Practice Address - Country:US
Practice Address - Phone:218-979-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service