Provider Demographics
NPI:1639317985
Name:VICTFORCE, INC
Entity Type:Organization
Organization Name:VICTFORCE, INC
Other - Org Name:WINDERMERE MEDICAL CLINIC AND SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYA
Authorized Official - Middle Name:VAMSI
Authorized Official - Last Name:BAYYAPUREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-374-1796
Mailing Address - Street 1:1535 BOOMER CIR
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6610
Mailing Address - Country:US
Mailing Address - Phone:678-957-9283
Mailing Address - Fax:
Practice Address - Street 1:3850 WINDERMERE PKWY
Practice Address - Street 2:SUITE #105
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7002
Practice Address - Country:US
Practice Address - Phone:404-374-1796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-24
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055177207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty