MEDICARE: REKIAT OLAYIWOLA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1831359	OTHER	OH	DODD

General Provider Information

NPI Number	:	1750984654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REKIAT OLAYIWOLA

Provider Business Mailing Address
First Line	:	5311 NORTHFIELD RD STE 410
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1135
Country	:	US
Telephone Number	:	216-402-9945
Fax Number	:

Provider Business Practice Location Address
First Line	:	5311 NORTHFIELD ROAD STE 410 ROOM 2
Second Line	:
City	:	BEDFORD HEIGHTS
State	:	OH
Zip	:	44146-1135
Country	:	US
Telephone Number	:	216-402-9945
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2020
Last Update Date	:	11/21/2020

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Directions to “ REKIAT OLAYIWOLA ” Practice Location

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