Organization
ONMO LLC
Active
Organization
ONMO LLC
Active
Parent organization
RAPHA MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAPHA MEDICAL CENTER
Authorized official
DR. AUGUSTINE O BOSAH MD (MANAGER)
(520) 458-4648
Entity
Organization
Contact information
Practice address
1939 FRONTAGE RD, SUITE G, SIERRA VISTA, AZ 85635-4638
(520) 458-4648
(520) 459-7945
Mailing address
1939 FRONTAGE RD, SUITE G, SIERRA VISTA, AZ 85635-4638
(520) 458-4648
(520) 459-7945
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
42980
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588794192
PERSONAL NPI
—
Enumeration date
07/28/2010
Last updated
07/29/2010
Update your record
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