Provider Demographics
NPI:1710630694
Name:RINCON OMS LLC
Entity Type:Organization
Organization Name:RINCON OMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING TEAM LEAD
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-354-1515
Mailing Address - Street 1:501 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2668
Mailing Address - Country:US
Mailing Address - Phone:912-354-1515
Mailing Address - Fax:912-354-8181
Practice Address - Street 1:613 TOWNE PARK DR W STE 301
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5258
Practice Address - Country:US
Practice Address - Phone:912-354-1515
Practice Address - Fax:912-354-8181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHATHAM ORAL SURGERY, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty