Provider Demographics
NPI:1164135547
Name:VINNYS MEDICAL LLC
Entity Type:Organization
Organization Name:VINNYS MEDICAL LLC
Other - Org Name:VINNYS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENTIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADJEI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-488-2532
Mailing Address - Street 1:3980 CARISSA TRCE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-6174
Mailing Address - Country:US
Mailing Address - Phone:678-488-2532
Mailing Address - Fax:
Practice Address - Street 1:401 S MAIN ST STE A8
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1957
Practice Address - Country:US
Practice Address - Phone:470-560-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty