OMEGA HEALTH & WELLNESS
Ambulatory Health at University Blvd, Jacksonville, FL

License number
Florida 261QP3300X
Category
Ambulatory Health
Type
Pain
Owner
Name: MR. JAMES COKER
Title: ADMINISTRATOR
Phone: (904) 374-6498
Address
Address
3101 University Blvd S SUITE 203, Jacksonville, FL 32216
National Provider ID: 1063895753
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OMEGA HEALTH & WELLNESS INC

Jacksonville, FL  -  Venice, FL

Status:
Inactive
Doing business as:
Omega Health & Wellness
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Nov 1, 2010
Inactive since:
Dec 1, 2011
Phone:
(904) 374-6498 (Phone)
Addresses:
3101 University Blvd 203, Jacksonville, FL 32216 (Physical)
2895 Egret Ct, North Port, FL 34287 (Mailing)
837 Laurel Ave, Venice, FL 34285
3101 University Blvd S, Jacksonville, FL 32216
State ID:
P10000089342
Business type:
Florida Profit Corporation
Secretary, Treasurer, Director, President:
James H Coker (Secretary, Treasurer, Director, President), 2895 Egret Ct, North Port, FL 34287 (Physical)
Agent:
James Coker,2895 Egret Ct, North Port, FL 34287 (Physical)
EIN:
273856290

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