Provider Demographics
NPI:1740430552
Name:OSO HOME CARE, INC.
Entity Type:Organization
Organization Name:OSO HOME CARE, INC.
Other - Org Name:OSO HOME CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-557-0308
Mailing Address - Street 1:1214 W BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1416
Mailing Address - Country:US
Mailing Address - Phone:818-557-0308
Mailing Address - Fax:818-433-7662
Practice Address - Street 1:1214 W BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-1416
Practice Address - Country:US
Practice Address - Phone:818-557-0308
Practice Address - Fax:818-433-7662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336C0004X, 3336L0003X, 3336S0011X
CA508503336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1740430552Medicaid
5631901OtherNCPDP PROVIDER IDENTIFICATION NUMBER