Healthcare Provider Details

I. General information

NPI: 1477394369
Provider Name (Legal Business Name): VERIFIED & VETTED COMPREHENSIVE TESTING AND SCREENING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 E MAIN ST STE 109
PLAINFIELD IN
46168-2827
US

IV. Provider business mailing address

2680 E MAIN ST STE 109
PLAINFIELD IN
46168-2827
US

V. Phone/Fax

Practice location:
  • Phone: 463-206-9070
  • Fax: 872-266-4374
Mailing address:
  • Phone: 463-206-9070
  • Fax: 872-266-4374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHARI COX
Title or Position: DIRECTOR
Credential: CPT
Phone: 463-206-9070