Provider Demographics
NPI:1790303428
Name:OZIMS PRIMARY HEALTH CENTER
Entity Type:Organization
Organization Name:OZIMS PRIMARY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IKENNA
Authorized Official - Middle Name:MADUFOR
Authorized Official - Last Name:OZIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-878-6442
Mailing Address - Street 1:625 UNION ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-2554
Mailing Address - Country:US
Mailing Address - Phone:201-878-6442
Mailing Address - Fax:
Practice Address - Street 1:625 UNION ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-2554
Practice Address - Country:US
Practice Address - Phone:201-878-6442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center