Basic Information
| Provider Information | |||||||||
| NPI: | 1689175846 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALUE IN PREVENTION OF MASSACHUSETTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 23057 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154481 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619824300 | ||||||||
| FaxNumber: | 5619536617 | ||||||||
| Practice Location | |||||||||
| Address1: | 257 STATION AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTH YARMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026641842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083942017 | ||||||||
| FaxNumber: | 5083986680 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2018 | ||||||||
| LastUpdateDate: | 07/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | KLEMES | ||||||||
| AuthorizedOfficialFirstName: | ANDREA | ||||||||
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| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5619824300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.