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Organization
OMNICARE MEDICAL CLINIC
Active
Organization
OMNICARE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABAYOMI R SANUSI MD (PRESIDENT)
(985) 879-3600
Entity
Organization
Contact information
Practice address
325 LIBERTY ST, HOUMA, LA 70360-4425
(985) 879-3600
(985) 879-3605
Mailing address
PO BOX 981, HOUMA, LA 70361-0981
(985) 879-3600
(985) 879-3605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
202838
LA
Other
Enumeration date
06/02/2009
Last updated
06/02/2009
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