Healthcare Provider Details

I. General information

NPI: 1114268380
Provider Name (Legal Business Name): MARIETTA OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 TOWER RD NE
MARIETTA GA
30060-6947
US

IV. Provider business mailing address

6 CADILLAC DR SUITE 310
BRENTWOOD TN
37027-5080
US

V. Phone/Fax

Practice location:
  • Phone: 770-422-8913
  • Fax: 770-425-2085
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM D. ORAND
Title or Position: CEO
Credential:
Phone: 615-250-7100