institution
Omnicare Labs Of Champaign Inc
Prosthetic/Orthotic Supplier in Urbana, Illinois
NPI 1720142094

Omnicare Labs Of Champaign Inc is a Prosthetic/Orthotic Supplier based in Urbana, IL. Omnicare Labs Of Champaign Inc practices in Urbana, IL. The NPI Number for Omnicare Labs Of Champaign Inc is 1720142094 and holds a License No. 211000198 (Illinois).

The current practice location address for Omnicare Labs Of Champaign Inc is 502 S Vine St, Urbana, IL and can be reached out via phone at 217-344-6664 and via fax at 217-344-9282. You can also correspond with Omnicare Labs Of Champaign Inc through the mailing address at 502 S VINE ST, URBANA, IL - 61801-4220 (mailing address contact number: 217-344-6664).

Location: 502 S Vine St, Urbana, IL, 61801-4220
institution
Provider Profile Details
NPI Number
1720142094
Provider Name
Omnicare Labs Of Champaign Inc
Credential
Provider Entity Type
Organization
Address
502 S Vine St, Urbana, IL, 61801-4220
Phone Number
217-344-6664
Fax Number
217-344-9282
Provider Enumeration Date
12/21/2006
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
082258 01 IL HEALTH ALLIANCE
01032029 01 IL BLUECROSS BLUESHIELD
02628 01 IL ABC CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
502 S Vine St
City
State
Zip
61801-4220
Phone Number
217-344-6664
Fax Number
217-344-9282
person
Provider Business Mailing Address Details
Address
502 S Vine St
City
State
Zip
61801-4220
Phone Number
217-344-6664
Fax Number
217-344-9282
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
License No.
211000198 (Illinois)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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