Provider Demographics
NPI:1184486169
Name:VALUE IN PREVENTION OF GEORGIA ROSWELL LLC
Entity type:Organization
Organization Name:VALUE IN PREVENTION OF GEORGIA ROSWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-982-4300
Mailing Address - Street 1:4950 COMMUNICATION AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-3307
Mailing Address - Country:US
Mailing Address - Phone:561-400-2713
Mailing Address - Fax:561-455-9215
Practice Address - Street 1:1265 UPPER HEMBREE RD STE 200
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1258
Practice Address - Country:US
Practice Address - Phone:770-442-9982
Practice Address - Fax:770-442-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty