Provider Demographics
NPI:1548409089
Name:VMP, LLC
Entity Type:Organization
Organization Name:VMP, LLC
Other - Org Name:FED, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:GENETICS / MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:DOUGHERTY
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-720-0820
Mailing Address - Street 1:5579 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:STE 110
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4128
Mailing Address - Country:US
Mailing Address - Phone:404-720-0820
Mailing Address - Fax:866-744-5665
Practice Address - Street 1:1875 OLD ALABAMA RD
Practice Address - Street 2:STE 220
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2272
Practice Address - Country:US
Practice Address - Phone:404-720-0820
Practice Address - Fax:866-744-5665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044706261QG0250X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics