Provider Demographics
NPI:1972142818
Name:OLYPMUS MEDICAL TRANSPORTATION INC
Entity type:Organization
Organization Name:OLYPMUS MEDICAL TRANSPORTATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:INA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVAKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-277-7777
Mailing Address - Street 1:4100 W ALAMEDA AVE STE 337
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4153
Mailing Address - Country:US
Mailing Address - Phone:747-277-7773
Mailing Address - Fax:
Practice Address - Street 1:4100 W ALAMEDA AVE STE 337
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4153
Practice Address - Country:US
Practice Address - Phone:747-277-7773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-23
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)