Provider Demographics
NPI:1215593215
Name:OLYMPUS HOME HEALTH INC
Entity Type:Organization
Organization Name:OLYMPUS HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAISON
Authorized Official - Middle Name:
Authorized Official - Last Name:KURUVILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-263-7236
Mailing Address - Street 1:2804 HELEN LN
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1862
Mailing Address - Country:US
Mailing Address - Phone:214-263-7236
Mailing Address - Fax:
Practice Address - Street 1:701 HIGHWAY 352 STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6898
Practice Address - Country:US
Practice Address - Phone:214-785-0542
Practice Address - Fax:214-785-0545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-15
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health