1366804270 NPI number — VALUE IN PREVENTION OF GEORGIA, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366804270 NPI number — VALUE IN PREVENTION OF GEORGIA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALUE IN PREVENTION OF GEORGIA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366804270
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4950 COMMUNICATION AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-3307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-982-4300
Provider Business Mailing Address Fax Number:
561-953-6617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
790 CHURCH ST NE STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30060-8957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-874-9739
Provider Business Practice Location Address Fax Number:
770-427-0180
Provider Enumeration Date:
03/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
KLEMES
Authorized Official First Name:
ANDREA
Authorized Official Middle Name:
Authorized Official Title or Position:
SOLE MEMBER
Authorized Official Telephone Number:
561-982-4300

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  034626 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com