Provider Demographics
NPI:1881909331
Name:OLYMPUS REIMBURSEMENT LLC.
Entity type:Organization
Organization Name:OLYMPUS REIMBURSEMENT LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR VISION GROUP
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-618-8791
Mailing Address - Street 1:358 E 1720 N
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-3110
Mailing Address - Country:US
Mailing Address - Phone:801-618-8791
Mailing Address - Fax:
Practice Address - Street 1:358 E 1720 N
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-3110
Practice Address - Country:US
Practice Address - Phone:801-618-8791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT193200000X332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies