Provider Demographics
NPI:1437101672
Name:OMNICARE HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:OMNICARE HEALTH CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-447-0220
Mailing Address - Street 1:5068 W PLANO PKWY
Mailing Address - Street 2:SUITE 224
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4408
Mailing Address - Country:US
Mailing Address - Phone:972-447-0220
Mailing Address - Fax:
Practice Address - Street 1:5068 W PLANO PKWY
Practice Address - Street 2:SUITE 224
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4408
Practice Address - Country:US
Practice Address - Phone:972-447-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center