Outreach Medical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

OUTREACH MEDICAL, INC.

Practice address

1123 7TH Ave
Suite 4
Rock Island, IL 61201-8449

Phone

(309) 786-3541

Fax

(309) 786-4573

NPI assigned

May 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Uche Mbakwe

Title

Vice President

Phone

(309) 786-3541

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1447200027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 7TH AVE",
            "address_2": "SUITE 4",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018449",
            "telephone_number": "309-786-3541",
            "fax_number": "309-786-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 7TH AVE",
            "address_2": "SUITE 4",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612018449",
            "telephone_number": "309-786-3541",
            "fax_number": "309-786-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTREACH MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MBAKWE",
        "authorized_official_first_name": "UCHE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "309-786-3541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0578344",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Occupational Health Centers of Illinois, P.C.
• Occupational Health Centers of Illinois, P.C.
• Valerie S Olson, LCPC
• Ora Orthopedics PC
• Outreach Homehealth Services, Inc.
• Gloria Pagan, MS CCC-SLP
• Sanjay Suryakant Pancholi, D.O.
• Caleb Paniamogan, DO
• Kerry P Panozzo, MD
• Albert Park, MD

• Durable Medical Equipment & Medical Supplies in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.