NPIMap

Organization Active NPI

Odin Health and Rehab Center LLC

  • Oxygen Equipment & Supplies (DME)
  • Odin, IL
National Provider Identifier
1174288096
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
ODIN HEALTH AND REHAB CENTER LLC
Practice address
300 Green St
Odin, IL 62870-1062
Phone
(618) 775-6444
NPI assigned
Nov 4, 2021
Last updated
Dec 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shalom Lichtman
Title
Manager
Phone
(618) 775-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X Primary

Addresses

Primary practice location

300 Green St
Odin, IL 62870-1062

Mailing address

575 Route 70
Brick, NJ 08723-4042

National Provider Directory

National Provider Directory
Tax ID family
Odin Health and Rehab Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1174288096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087234042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GREEN ST",
            "city": "ODIN",
            "state": "IL",
            "postal_code": "628701062",
            "telephone_number": "618-775-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODIN HEALTH AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "LICHTMAN",
        "authorized_official_first_name": "SHALOM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "618-775-6444"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.