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Organization

MOH INTEGRATED SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
OLUWASEUN MODUPE ONIFADE NP (NURSE PRACTITIONER)
(317) 332-9667
Entity
Organization

Contact information

Practice address
13192 GLENSIDE DR, FISHERS, IN 46037-8864
(317) 332-9667
Mailing address
13192 GLENSIDE DR, FISHERS, IN 46037-8864
(317) 332-9667

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251J00000X
Nursing Care Agency
Primary
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
02/03/2025
Last updated
03/13/2025
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