Provider Demographics
NPI:1922385491
Name:OLYMPUS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:OLYMPUS HEALTHCARE, LLC
Other - Org Name:OLYMPUS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-969-9886
Mailing Address - Street 1:1005 E 10TH ST
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5127
Mailing Address - Country:US
Mailing Address - Phone:956-969-9886
Mailing Address - Fax:956-969-4068
Practice Address - Street 1:1005 E 10TH ST
Practice Address - Street 2:SUITE A-2
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5133
Practice Address - Country:US
Practice Address - Phone:956-969-9886
Practice Address - Fax:956-969-9965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health