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General NPI Number Information
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NPI Number | 1508703984
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Entity Type | Organization
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Legal Business Name | VICTORY MEDICAL SERVICES LLC
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Dates
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Enumeration Date | 05/02/2026
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Last Update Date | 05/02/2026
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Provider Practice Location Address
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Address Line | 2675 MALL OF GEORGIA BLVD STE 304
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City | BUFORD
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State | GA
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Zip | 30519-8783
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Country | US
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Telephone | 404-453-6010
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Fax | 470-742-7404
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Provider Business Mailing Address
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Address Line | 2675 MALL OF GEORGIA BLVD STE 304
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City | BUFORD
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State | GA
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Zip | 30519-8783
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Country | US
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Telephone | 404-453-6010
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Fax | 470-742-7404
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Authorized Official
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Title or Position | CEO
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Name | TABITHA LOPEZ
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Credential |
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Telephone | 404-453-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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