Provider Demographics
NPI:1184775637
Name:OMEGA CARE SERVICES, INC
Entity type:Organization
Organization Name:OMEGA CARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:KWAKU
Authorized Official - Last Name:DUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-584-6900
Mailing Address - Street 1:32 E KINGSBRIDGE RD
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-7513
Mailing Address - Country:US
Mailing Address - Phone:718-584-6900
Mailing Address - Fax:718-584-6901
Practice Address - Street 1:32 E KINGSBRIDGE RD
Practice Address - Street 2:SUITE 2E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-7513
Practice Address - Country:US
Practice Address - Phone:718-584-6900
Practice Address - Fax:718-584-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1285L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02820482Medicaid