Provider Demographics
NPI:1093485906
Name:OLIVERO, DON J
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:J
Last Name:OLIVERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GATE 11
Mailing Address - Street 2:
Mailing Address - City:CAROLINA SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:28467-2621
Mailing Address - Country:US
Mailing Address - Phone:716-912-7850
Mailing Address - Fax:
Practice Address - Street 1:23 GATE 11
Practice Address - Street 2:
Practice Address - City:CAROLINA SHORES
Practice Address - State:NC
Practice Address - Zip Code:28467-2621
Practice Address - Country:US
Practice Address - Phone:716-912-7850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)