Provider Demographics
NPI:1558854562
Name:ALPHA OMEGA STAFFING, LLC
Entity Type:Organization
Organization Name:ALPHA OMEGA STAFFING, LLC
Other - Org Name:ALPHA OMEGA STAFFING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLAYEMI AWOSANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:920-268-5215
Mailing Address - Street 1:2655 DANIEL PARK RUN
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7823
Mailing Address - Country:US
Mailing Address - Phone:920-268-5215
Mailing Address - Fax:920-358-5026
Practice Address - Street 1:2655 DANIEL PARK RUN
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7823
Practice Address - Country:US
Practice Address - Phone:920-268-5215
Practice Address - Fax:920-358-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-13
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067-R-1999251F00000X, 253Z00000X
067-R-1999251J00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251F00000XAgenciesHome Infusion
No253Z00000XAgenciesIn Home Supportive Care