Provider Demographics
NPI:1588307490
Name:OXOS HEALTHCARE SERVICES GA LLC
Entity type:Organization
Organization Name:OXOS HEALTHCARE SERVICES GA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF STRATEGY AND OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DEV
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDAVIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-490-6549
Mailing Address - Street 1:1230 PEACHTREE ST NE STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1230 PEACHTREE ST NE STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3565
Practice Address - Country:US
Practice Address - Phone:855-733-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty