Provider Demographics
NPI:1295972370
Name:OLGA MEDICAL DISTRIBUTORS INC.
Entity type:Organization
Organization Name:OLGA MEDICAL DISTRIBUTORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GANIAT
Authorized Official - Middle Name:O
Authorized Official - Last Name:OKANLAWON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-414-4537
Mailing Address - Street 1:335 W ARBOR VITAE ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90301-3767
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:335 W ARBOR VITAE ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-3767
Practice Address - Country:US
Practice Address - Phone:908-414-4537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies