Provider Demographics
NPI:1326673344
Name:OS1 MANAGEMENT LLC
Entity Type:Organization
Organization Name:OS1 MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-315-3678
Mailing Address - Street 1:1031 BROCKS GAP PKWY STE 185
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-4078
Mailing Address - Country:US
Mailing Address - Phone:888-315-3678
Mailing Address - Fax:205-383-1251
Practice Address - Street 1:1031 BROCKS GAP PKWY STE 185
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4078
Practice Address - Country:US
Practice Address - Phone:888-315-3678
Practice Address - Fax:205-383-1251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL163WX0800XOtherTAXONOMY