Healthcare Provider Details

I. General information

NPI: 1891398996
Provider Name (Legal Business Name): VIRAL VIGILANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 11/19/2020
Certification Date: 11/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 CHEVRON WAY
SANDY SPRINGS GA
30350-4431
US

IV. Provider business mailing address

2090 DUNWOODY CLUB DR STE 106-225
ATLANTA GA
30350-5434
US

V. Phone/Fax

Practice location:
  • Phone: 229-220-5674
  • Fax:
Mailing address:
  • Phone: 770-912-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WINSTON PRICE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 229-220-5674