Provider Demographics
NPI:1679362396
Name:OMNIMED WELLNESS SOLUTIONS
Entity type:Organization
Organization Name:OMNIMED WELLNESS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CORINTHIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-610-9447
Mailing Address - Street 1:PO BOX 872
Mailing Address - Street 2:
Mailing Address - City:SAINT GABRIEL
Mailing Address - State:LA
Mailing Address - Zip Code:70776-0872
Mailing Address - Country:US
Mailing Address - Phone:225-610-9447
Mailing Address - Fax:
Practice Address - Street 1:10202 PERKINS ROWE STE E160
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2067
Practice Address - Country:US
Practice Address - Phone:225-610-9447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare