Organization
OMNI ORTHOPEDIC SERVICES INC
Active
Other names
OmniCare Labs Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID PROCTER C.P.O. (PRESIDENT)
(217) 347-2800
Entity
Organization
Contact information
Practice address
108 W WASHINGTON AVE, EFFINGHAM, IL 62401-2354
(217) 347-2800
(217) 347-2812
Mailing address
108 W WASHINGTON AVE, EFFINGHAM, IL 62401-2354
(217) 347-2800
(217) 347-2812
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2570567
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/14/2007
Last updated
04/20/2008
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