Provider Demographics
NPI:1154466647
Name:OSAMA SAAD HINDASH
Entity Type:Organization
Organization Name:OSAMA SAAD HINDASH
Other - Org Name:AZURE FOR HEALTH & HUMAN SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSAMA
Authorized Official - Middle Name:SAAD
Authorized Official - Last Name:HINDASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-799-9277
Mailing Address - Street 1:801 MACY DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-6333
Mailing Address - Country:US
Mailing Address - Phone:678-799-9277
Mailing Address - Fax:678-795-9709
Practice Address - Street 1:801 MACY DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-6333
Practice Address - Country:US
Practice Address - Phone:678-799-9277
Practice Address - Fax:678-795-9709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035652261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300766339OtherMAGELLAN
GA3503338OtherAETNA
GA52624445 006OtherBLUE CROSS BLUE SHIELD
GA209235687AMedicaid
GA1545911OtherCAQH
GA26BDHRJMedicare PIN
GA300766339OtherMAGELLAN