Individual ProviderOlive UwamaliyaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address13135 Lee Jackson Memorial Hwy Ste 135, Fairfax, VA 22033-1907(703) 961-0488PECOS EnrollmentBased on the most recent information from CMS, provider Olive Uwamaliya is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1750011714Provider TypeIndividualFull NameUwamaliya, OliveTitleMs.CredentialMSN APRN FNP-CGenderFemaleSole ProprietorNoEnumeration Date6/13/2022Last Updated6/13/2022Contact InformationPractice LocationPractice Address13135 Lee Jackson Memorial Hwy Ste 135, Fairfax, VA 22033-1907Phone(703) 961-0488Fax(703) 961-0480Mailing LocationMailing Address13135 Lee Jackson Memorial Hwy Ste 135, Fairfax, VA 22033-1907Phone(703) 961-0488Fax(703) 961-0480Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense0024184457VirginiaProvider IdentifiersIDDescriptionIssuerID541130380DescriptionMedicaidIssuerUnlistedVirginia