MEDICARE: OLMSTED HEALTH & SERVICES CORP.

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	207R00000X	Internal Medicine Physician

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

General Provider Information

NPI Number	:	1851370647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLMSTED HEALTH & SERVICES CORP.

Provider Business Mailing Address
First Line	:	PO BOX 246
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-0246
Country	:	US
Telephone Number	:	440-777-6017
Fax Number	:	440-777-6940

Provider Business Practice Location Address
First Line	:	26376 JOHN RD
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-1277
Country	:	US
Telephone Number	:	440-235-7100
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MATTHEW WAYNE
Credential	:	MD
Telephone Number	:	440-235-7100

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	08/22/2020

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