Provider Demographics
NPI:1366330441
Name:OSCAR, AMON M
Entity type:Individual
Prefix:
First Name:AMON
Middle Name:M
Last Name:OSCAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16524 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1629
Mailing Address - Country:US
Mailing Address - Phone:513-765-0073
Mailing Address - Fax:513-765-0073
Practice Address - Street 1:923 GALVIN RD S UNIT 10512106
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2202
Practice Address - Country:US
Practice Address - Phone:513-253-5428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115146376K00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No376K00000XNursing Service Related ProvidersNurse's Aide