MEDICARE: OLAY HOME AND FACILITY BATH SERVICES

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1831541655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLAY HOME AND FACILITY BATH SERVICES

Provider Business Mailing Address
First Line	:	3718 N SAINT LUCIE DR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4614
Country	:	US
Telephone Number	:	407-732-3784
Fax Number	:

Provider Business Practice Location Address
First Line	:	3718 N SAINT LUCIE DR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4614
Country	:	US
Telephone Number	:	407-732-3784
Fax Number	:

Authorized Official
Title or Position	:	PRESIDETN
Name	:	MADJA OLAY
Credential	:
Telephone Number	:	407-732-3784

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	07/27/2016

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