Omni Medical Supply Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OMNI MEDICAL SUPPLY INC

Practice address

5518 Park Thicket LN
Rosharon, TX 77583-2144

Phone

(888) 664-0032

Fax

(346) 816-7690

NPI assigned

Oct 28, 2019

Organization subpart

No

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

Authorized official

Name

Keith Jason Hebert

Title

Owner

Phone

(888) 664-0032

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Omni Medical Supply Inc Doing business as

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1336782812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5518 PARK THICKET LN",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775832144",
            "telephone_number": "866-542-3020",
            "fax_number": "281-431-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5518 PARK THICKET LN",
            "city": "ROSHARON",
            "state": "TX",
            "postal_code": "775832144",
            "telephone_number": "888-664-0032",
            "fax_number": "346-816-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI MEDICAL SUPPLY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-28",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "HEBERT",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-664-0032"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4096315-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Omni Medical Supply Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Omni Medical Supply Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Rosharon, TX
• Providers in Rosharon, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.