Healthcare Provider Details

I. General information

NPI: 1710043237
Provider Name (Legal Business Name): VPC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 10/18/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 HARRIS INDUSTRIAL BLVD. STE 3
VIDALIA GA
30474-8854
US

IV. Provider business mailing address

303 HARRIS INDUSTRIAL BLVD. STE 3
VIDALIA GA
30474-8854
US

V. Phone/Fax

Practice location:
  • Phone: 912-537-9355
  • Fax: 912-373-8096
Mailing address:
  • Phone: 912-537-9355
  • Fax: 912-373-8096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARSON HUGH SMITH
Title or Position: C.O.O./CO-OWNER
Credential:
Phone: 912-537-9355