1013284546 NPI number — THE OLISA FOUNDATION

Table of content: (NPI 1013284546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013284546 NPI number — THE OLISA FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE OLISA FOUNDATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMERICAN JOURNAL OF BIOLOGICAL DEFENSE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013284546
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3601 PICKETT RD UNIT 2121
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-8107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-208-4431
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7362 REMCON CIR STE 644
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79912-1623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-208-4431
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
OLISA
Authorized Official First Name:
NZEDEGWU
Authorized Official Middle Name:
ROBERT
Authorized Official Title or Position:
LABORATORY TECHNICAL DIRECTOR
Authorized Official Telephone Number:
915-208-4431

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  M (ASCP) 3555 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BP3500X , with the licence number: RM (NRCM) 55214696 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335G00000X , with the licence number: NAFDAC A7469L , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9068479 . This is a "CAP" identifier . This identifiers is of the category "OTHER".




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