Provider Demographics
NPI:1255199923
Name:OLIVER HEALTH TECHNOLOGIES, LLC
Entity type:Organization
Organization Name:OLIVER HEALTH TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GERMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:315-681-8227
Mailing Address - Street 1:15 WOODHILL RD
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9743
Mailing Address - Country:US
Mailing Address - Phone:315-681-8227
Mailing Address - Fax:
Practice Address - Street 1:1448 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-1269
Practice Address - Country:US
Practice Address - Phone:413-283-2946
Practice Address - Fax:413-283-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center