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Evelyn Nwangulor Ogbomoh

Student in an Organized Health Care Education/Training Program

Student, Health Care

809 82nd Parkway, Myrtle Beach, SC 29572

PECOS Enrollment

This provider is enrolled in PECOS as EVELYN OGBOMOH.

Based on the most recent information from CMS, provider Evelyn Nwangulor Ogbomoh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:05 AM.

Profile Details

Provider ID
1265877807
Provider Type
Individual
Full Name
Ogbomoh, Evelyn Nwangulor
Title
Dr.
Credential
MD

Gender
Female
Sole Proprietor
No
Enumeration Date
5/9/2013
Last Updated
6/7/2023

Contact Information

Practice Location

809 82nd Parkway, Myrtle Beach, SC 29572

(843) 692-3497

Unlisted Fax

Mailing Location

809 82nd Pkwy Ofc 113, Myrtle Beach, SC 29572-4607

(843) 692-3497

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Evelyn Nwangulor Ogbomoh

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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