Omni Clinic Pa

LBN: Omni Clinic Pa
Omni Clinic Pa is an health care organization with primary practice located at 22 Office Park Dr , Jacksonville NC 28546-7325. The organization recently has only one registered license in Managed Care Organizations / Exclusive Provider Organization, which is considered as the primary health care specialty. Omni Clinic Pa can be contacted via phone (910) 219-4070, or through Burkett, Teresa via phone (910) 219-4070.

Contact Information

Primary practice address
22 Office Park Dr Jacksonville NC 28546-7325
Phone: (910) 219-4070
Fax: (910) 219-4071
Website:
Map and Directions
Authorized official contact:
Name: Burkett, Teresa
Phone: (910) 219-4070

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Exclusive Provider Organization 302F00000X 9901455 North Carolina

Profile Details

NPI number 1790748960
LBN Legal business name Omni Clinic Pa
DBA Doing business as
Authorized official Burkett, Teresa
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2006
Last updated Aug 19th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790748960 NPPES
North Carolina MEDICAID 5909266

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