Healthcare Provider Details

I. General information

NPI: 1457080863
Provider Name (Legal Business Name): OLMI MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5052 POPE JOHN PAUL 11 BLVD
AVE MARIA FL
34142
US

IV. Provider business mailing address

5052 POPE JOHN PAUL 11 BLVD
AVE MARIA FL
34142-9576
US

V. Phone/Fax

Practice location:
  • Phone: 866-970-2965
  • Fax:
Mailing address:
  • Phone: 866-970-2965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NICOLE OLMINO
Title or Position: OWNER
Credential:
Phone: 866-970-2965