Provider Demographics
NPI:1356576110
Name:AHAOMA B OHIA
Entity type:Organization
Organization Name:AHAOMA B OHIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AHAOMA
Authorized Official - Middle Name:BONIFACE
Authorized Official - Last Name:OHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-924-7080
Mailing Address - Street 1:1821 WOODDALE CT
Mailing Address - Street 2:STE. 210
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-1535
Mailing Address - Country:US
Mailing Address - Phone:225-924-7080
Mailing Address - Fax:225-923-3528
Practice Address - Street 1:1821 WOODDALE CT
Practice Address - Street 2:STE. 210
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-1535
Practice Address - Country:US
Practice Address - Phone:225-924-7080
Practice Address - Fax:225-923-3528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHAOMA B OHIA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-22
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1356576110OtherNPI
LA4669160001Medicare NSC