Provider Demographics
NPI:1902402894
Name:OMNIACARE LLC
Entity Type:Organization
Organization Name:OMNIACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:BARBEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:435-467-8201
Mailing Address - Street 1:1977 E 2590 SOUTH CIR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7024
Mailing Address - Country:US
Mailing Address - Phone:435-467-8201
Mailing Address - Fax:
Practice Address - Street 1:350 FALCON RIDGE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-8879
Practice Address - Country:US
Practice Address - Phone:702-849-0585
Practice Address - Fax:702-849-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based