Organization
THE VIGOR CONSORTIUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC ALLEN MBA PH (EXECUTIVE DIRECTOR)
(404) 538-4945
Entity
Organization
Contact information
Practice address
1230 PEACHTREE ST, SUITE 1800, ATLANTA, GA 30309-3574
(404) 538-4945
Mailing address
1230 PEACHTREE ST, SUITE 1800, ATLANTA, GA 30309-3574
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130800108
—
GA
05
—
36060083
—
GA
05
—
380680287
—
GA
Enumeration date
12/27/2010
Last updated
12/27/2010
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