Organization
PRIVATELY YOURS BY OMA
Active
Other names
Oma Louise P Wilson
Organization subpart
No
Provider details
NPI number
Authorized official
OMA P WILSON (SOLE OWNER)
(315) 789-2354
Entity
Organization
Contact information
Practice address
1943 ROUTE 14 N, GENEVA, NY 14456
(315) 789-2354
Mailing address
2413 CARTER RD, GENEVA, NY 14456
(315) 789-2354
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NO LISCENSE REQUIRED
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00757199
—
NY
01
—
111353AU
PREFERRED CARE
NY
01
—
OW241144
EXCELLUS BLUE CROSS BLUE
NY
Enumeration date
11/28/2006
Last updated
07/23/2008
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