Provider Demographics
NPI:1245020866
Name:OLMEDA, AIDA
Entity type:Individual
Prefix:
First Name:AIDA
Middle Name:
Last Name:OLMEDA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33760 HENWELL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA STATION
Mailing Address - State:OH
Mailing Address - Zip Code:44028-9149
Mailing Address - Country:US
Mailing Address - Phone:440-783-0792
Mailing Address - Fax:
Practice Address - Street 1:33760 HENWELL RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA STATION
Practice Address - State:OH
Practice Address - Zip Code:44028-9149
Practice Address - Country:US
Practice Address - Phone:440-783-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator