Organization
OSA-VA-NETWORK-GA INC
Active
Organization
OSA-VA-NETWORK-GA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HETESH RANCHOD (MEDICAL DIRECTOR)
(770) 856-5071
Entity
Organization
Contact information
Practice address
683 PIEDMONT RD NE, MARIETTA, GA 30066-4811
(770) 856-5071
Mailing address
2437 ROCKVILLE CENTRE PKWY, OCEANSIDE, NY 11572-1622
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN011401
LICENSURE
GA
Enumeration date
03/01/2024
Last updated
04/01/2024
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