Provider Demographics
NPI:1407593080
Name:OLIVERO MEDICAL HEALTH CENTER
Entity Type:Organization
Organization Name:OLIVERO MEDICAL HEALTH CENTER
Other - Org Name:OLIVERO MEDICAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-499-3009
Mailing Address - Street 1:1243 SKYTOP MOUNTAIN RD # R1
Mailing Address - Street 2:
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-7725
Mailing Address - Country:US
Mailing Address - Phone:814-499-3009
Mailing Address - Fax:814-470-4421
Practice Address - Street 1:1243 SKYTOP MOUNTAIN RD # R1
Practice Address - Street 2:
Practice Address - City:PORT MATILDA
Practice Address - State:PA
Practice Address - Zip Code:16870-7725
Practice Address - Country:US
Practice Address - Phone:814-499-3009
Practice Address - Fax:814-470-4421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLIVERO MEDICAL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-16
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory