Provider Demographics
NPI:1467732693
Name:VIDA BILLING SERVICES
Entity Type:Organization
Organization Name:VIDA BILLING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEMAYOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-469-6846
Mailing Address - Street 1:1851 MARKET ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-3135
Mailing Address - Country:US
Mailing Address - Phone:678-468-6846
Mailing Address - Fax:888-207-4322
Practice Address - Street 1:1851 MARKET ST
Practice Address - Street 2:SUITE 104
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-3134
Practice Address - Country:US
Practice Address - Phone:678-468-6846
Practice Address - Fax:888-207-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty