Vina Health Care Clinic Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

040894 Issued in GA

Legal business name

VINA HEALTH CARE CLINIC CORPORATION

Practice address

4487 Jonesboro Rd
Forest Park, GA 30297-4316

Phone

(404) 366-8822

Fax

(404) 366-8824

NPI assigned

Jan 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ly Dam

Title

Office Manager

Phone

(404) 366-8822

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VINA HEALTH CARE CLINIC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1487634648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4487 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302974316",
            "telephone_number": "404-366-8822",
            "fax_number": "404-366-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302974316",
            "telephone_number": "404-366-8822",
            "fax_number": "404-366-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINA HEALTH CARE CLINIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-21",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "DAM",
        "authorized_official_first_name": "LY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "404-366-8822",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "GA",
            "license": "040894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000766884A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VINA HEALTH CARE CLINIC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Truliant Health Systems LLC and Plaza Consultants LLC a Partnership
• Trustee Drugs, Inc.
• Unimedical,PC
• Niambi Vantress
• Yosan Negga Vilfort, PA-C
• Zoe Vinci
• Vital Link Transport LLC
• Walgreen Co
• India Cristiana Walker
• Gwen Warner

• General Practice Physician in Forest Park, GA
• Providers in Forest Park, GA by specialty
• General Practice Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.