Provider Demographics
NPI:1770947830
Name:BOLARINWA, OLUSHOLA
Entity type:Individual
Prefix:
First Name:OLUSHOLA
Middle Name:
Last Name:BOLARINWA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3177 SARINA CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2742
Mailing Address - Country:US
Mailing Address - Phone:808-675-1236
Mailing Address - Fax:
Practice Address - Street 1:3177 SARINA CIR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2742
Practice Address - Country:US
Practice Address - Phone:915-539-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)