Provider Demographics
NPI:1649968249
Name:OMNIPRE HEALTH CARE STAFFING LLC
Entity type:Organization
Organization Name:OMNIPRE HEALTH CARE STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MODELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGEONE-ETIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:617-823-5534
Mailing Address - Street 1:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-0245
Mailing Address - Country:US
Mailing Address - Phone:508-272-4390
Mailing Address - Fax:
Practice Address - Street 1:14 JULIE RD
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-2144
Practice Address - Country:US
Practice Address - Phone:617-823-5534
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service