1538881297 NPI number — OPTIMUM HEALTHCARE SERVICES LLC

Table of content: (NPI 1538881297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538881297 NPI number — OPTIMUM HEALTHCARE SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPTIMUM HEALTHCARE SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538881297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
152 SE SLOAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAUKEE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50263-1268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-968-5237
Provider Business Mailing Address Fax Number:
515-984-8143

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FRANKLIN TIKU
Provider Second Line Business Practice Location Address:
152 SE SOAN DR
Provider Business Practice Location Address City Name:
WAUKEE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-968-5237
Provider Business Practice Location Address Fax Number:
515-984-8143
Provider Enumeration Date:
09/19/2022

Additional Information

Authorized Official

Authorized Official Last Name:
TIKU
Authorized Official First Name:
FRANKLIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
405-968-5237

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com