Organization
OMNILIFE SYSTEMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C BANASIK (PRESIDENT)
(614) 299-3100
Entity
Organization
Contact information
Practice address
50 W 5TH AVE, COLUMBUS, OH 43201-3219
(614) 299-3100
(614) 299-3813
Mailing address
PO BOX 8309, 50 W FIFTH AVE, COLUMBUS, OH 43201-0309
(614) 299-3100
(614) 299-3813
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36H115
MEDICARE
OH
Enumeration date
08/27/2010
Last updated
08/27/2010
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