Provider Demographics
NPI:1730625161
Name:OLAYEMI, OLAJUMOKE
Entity type:Individual
Prefix:
First Name:OLAJUMOKE
Middle Name:
Last Name:OLAYEMI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24523 FOREST CANOPY DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1886
Mailing Address - Country:US
Mailing Address - Phone:973-454-1952
Mailing Address - Fax:
Practice Address - Street 1:24523 FOREST CANOPY DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1886
Practice Address - Country:US
Practice Address - Phone:973-454-1952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-09
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171WV0202XOther Service ProvidersContractorVehicle Modifications
No172A00000XOther Service ProvidersDriver
No374U00000XNursing Service Related ProvidersHome Health Aide