Provider Demographics
NPI:1629499876
Name:AREMU, OMONIKE
Entity Type:Individual
Prefix:
First Name:OMONIKE
Middle Name:
Last Name:AREMU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 NORTHWINDS PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-4807
Mailing Address - Country:US
Mailing Address - Phone:770-753-6021
Mailing Address - Fax:770-476-2107
Practice Address - Street 1:2475 NORTHWINDS PKWY
Practice Address - Street 2:STE 200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-4807
Practice Address - Country:US
Practice Address - Phone:770-753-6021
Practice Address - Fax:770-476-2107
Is Sole Proprietor?:No
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA663606744A374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA663606744AMedicaid