Healthcare Provider Details

I. General information

NPI: 1326702713
Provider Name (Legal Business Name): VIRTIS HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2021
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 RIVERCHASE CTR STE 310
HOOVER AL
35244-1855
US

IV. Provider business mailing address

2801 NETWORK BLVD STE 505
FRISCO TX
75034-1895
US

V. Phone/Fax

Practice location:
  • Phone: 205-994-7103
  • Fax: 208-588-0255
Mailing address:
  • Phone: 833-765-3648
  • Fax: 603-718-3824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RONALD P LINDAHL
Title or Position: COO
Credential:
Phone: 833-765-3648