Provider Demographics
NPI:1083808208
Name:OLIDIA CARE INC
Entity Type:Organization
Organization Name:OLIDIA CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLIVIER
Authorized Official - Middle Name:B
Authorized Official - Last Name:NKWONKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-567-7780
Mailing Address - Street 1:4105 85TH AVE N STE 101
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55443-2055
Mailing Address - Country:US
Mailing Address - Phone:763-634-5994
Mailing Address - Fax:763-634-5997
Practice Address - Street 1:7530 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3636
Practice Address - Country:US
Practice Address - Phone:763-634-5994
Practice Address - Fax:763-634-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25418251E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies