Provider Demographics
NPI:1619206919
Name:OCEANIC HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:OCEANIC HOME HEALTH AGENCY, INC
Other - Org Name:OCEANIC HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GOLDEN
Authorized Official - Middle Name:CHINONSO
Authorized Official - Last Name:KNABUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-943-8401
Mailing Address - Street 1:4031 N BELT LINE RD APT 1918
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-7147
Mailing Address - Country:US
Mailing Address - Phone:214-943-8401
Mailing Address - Fax:
Practice Address - Street 1:4031 N BELT LINE RD APT 1918
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-7147
Practice Address - Country:US
Practice Address - Phone:214-943-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health