Provider Demographics
NPI:1093468779
Name:OLIVE CARE SERVICES LLC
Entity Type:Organization
Organization Name:OLIVE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADESOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-574-3622
Mailing Address - Street 1:1167 W BALTIMORE PIKE STE 227
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5127
Mailing Address - Country:US
Mailing Address - Phone:267-574-3622
Mailing Address - Fax:
Practice Address - Street 1:1260 E WOODLAND AVE STE 214B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3969
Practice Address - Country:US
Practice Address - Phone:484-774-5473
Practice Address - Fax:484-750-5554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-01
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care