Individual
MR. SAMSON FOLORUNSHO OMOSOWON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, CSCM
Contact information
Practice address
4078 E ASPEN WAY, GILBERT, AZ 85234-7506
(480) 335-3099
(480) 621-8748
Mailing address
4078 E ASPEN WAY, GILBERT, AZ 85234-7506
(480) 335-3099
(480) 621-8748
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
RN156392
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
658864
—
AZ
05
—
RN156392
—
AZ
Enumeration date
07/17/2012
Last updated
07/17/2012
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