Provider Demographics
NPI:1366709362
Name:OLIINC MGMT & CONSULTING LLC
Entity type:Organization
Organization Name:OLIINC MGMT & CONSULTING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:OLIVERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-457-2928
Mailing Address - Street 1:1050 HIGHWAY 3 S
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55057-3088
Mailing Address - Country:US
Mailing Address - Phone:507-301-3701
Mailing Address - Fax:507-301-3703
Practice Address - Street 1:1050 HIGHWAY 3 S
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3088
Practice Address - Country:US
Practice Address - Phone:507-301-3701
Practice Address - Fax:507-301-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0082-0001448OtherMEDICA
MN0082-0001448OtherSELECT CARE
MN1366709362Medicaid
MN0082-0001448OtherSELECT CARE