Provider Demographics
NPI:1972484608
Name:KOSHALIVING LLC
Entity type:Organization
Organization Name:KOSHALIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR BUSINESS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ARTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-302-0499
Mailing Address - Street 1:PO BOX 13245
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-0245
Mailing Address - Country:US
Mailing Address - Phone:678-915-2929
Mailing Address - Fax:404-475-5571
Practice Address - Street 1:711 COSMOPOLITAN DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3600
Practice Address - Country:US
Practice Address - Phone:678-915-2929
Practice Address - Fax:404-475-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty