Provider Demographics
NPI:1063892776
Name:OLSEN MEDICAL SALES, LLC
Entity type:Organization
Organization Name:OLSEN MEDICAL SALES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:518-368-7400
Mailing Address - Street 1:98 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205
Mailing Address - Country:US
Mailing Address - Phone:518-459-4796
Mailing Address - Fax:518-453-9602
Practice Address - Street 1:98 EVERETT RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205
Practice Address - Country:US
Practice Address - Phone:518-459-4796
Practice Address - Fax:518-453-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies