Provider Demographics
NPI:1053453035
Name:OMNI SURGICAL, INC
Entity Type:Organization
Organization Name:OMNI SURGICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CSA
Authorized Official - Prefix:
Authorized Official - First Name:SCOT
Authorized Official - Middle Name:
Authorized Official - Last Name:FORTE
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:770-594-1351
Mailing Address - Street 1:8409 DUNWOODY PLACE
Mailing Address - Street 2:BUILDING 4
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350
Mailing Address - Country:US
Mailing Address - Phone:770-594-1351
Mailing Address - Fax:770-594-1381
Practice Address - Street 1:8409 DUNWOODY PLACE
Practice Address - Street 2:BUILDING 4
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350
Practice Address - Country:US
Practice Address - Phone:770-594-1351
Practice Address - Fax:770-594-1381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Multi-Specialty