Provider Demographics
NPI:1811519390
Name:OLYMPUS HEALTH AND PERFORMANCE
Entity type:Organization
Organization Name:OLYMPUS HEALTH AND PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF SCIENTIFIC OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-465-5152
Mailing Address - Street 1:2233 E MURRAY HOLLADAY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-5349
Mailing Address - Country:US
Mailing Address - Phone:385-645-6137
Mailing Address - Fax:
Practice Address - Street 1:2233 E MURRAY HOLLADAY RD
Practice Address - Street 2:
Practice Address - City:HOLLADAY
Practice Address - State:UT
Practice Address - Zip Code:84117-5349
Practice Address - Country:US
Practice Address - Phone:385-645-6137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy