Provider Demographics
NPI:1962842286
Name:WEAMA LLC
Entity Type:Organization
Organization Name:WEAMA LLC
Other - Org Name:SYNERGY HOMECARE OF EDMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WEAAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-254-3046
Mailing Address - Street 1:13720 N BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6464
Mailing Address - Country:US
Mailing Address - Phone:405-254-3046
Mailing Address - Fax:405-254-3072
Practice Address - Street 1:13720 N BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6464
Practice Address - Country:US
Practice Address - Phone:405-254-3046
Practice Address - Fax:405-254-3072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8011251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health