Healthcare Provider Details
I. General information
NPI: 1730863143
Provider Name (Legal Business Name): VRM MEDICAL, , LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2023
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1636 HIGDON FERRY RD # D
HOT SPRINGS AR
71913-6912
US
IV. Provider business mailing address
704 N HUGHES ST
LITTLE ROCK AR
72205-2819
US
V. Phone/Fax
- Phone: 501-651-2000
- Fax:
- Phone: 479-886-4755
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
VIRGIL
RUDOLPH
MASSEY
III
Title or Position: OWNER
Credential: MD
Phone: 479-886-4755