Omega of North Carolina, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1061647 Issued in NC

Legal business name

OMEGA OF NORTH CAROLINA, LLC

Practice address

110 Medical Dr
Suite 8
Elizabeth City, NC 27909-3374

Phone

(252) 338-5183

NPI assigned

Sep 9, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Deane Ellis

Title

Director of Operations

Phone

(804) 527-5337

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1245489780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 8",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093374",
            "telephone_number": "252-338-5183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MEDICAL DR",
            "address_2": "SUITE 8",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279093374",
            "telephone_number": "252-338-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA OF NORTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DEANE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "804-527-5337",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "1061647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Our Home Is Your Home

• Clinical Medical Laboratory in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.