Provider Demographics
NPI:1598421562
Name:ODEN, ROBBIN OSCAR
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:OSCAR
Last Name:ODEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22452
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-0452
Mailing Address - Country:US
Mailing Address - Phone:216-307-4140
Mailing Address - Fax:
Practice Address - Street 1:4133 BUSA OVAL
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-2229
Practice Address - Country:US
Practice Address - Phone:216-307-4140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty