Healthcare Provider Details

I. General information

NPI: 1972422426
Provider Name (Legal Business Name): VIRTUAL VILLAGE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 CANNERY LN
FOREST HILL MD
21050-3066
US

IV. Provider business mailing address

PO BOX 115
FOREST HILL MD
21050-0115
US

V. Phone/Fax

Practice location:
  • Phone: 717-824-6142
  • Fax: 417-201-1093
Mailing address:
  • Phone: 717-824-6142
  • Fax: 417-201-1093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JESSICS BENJES
Title or Position: OWNER
Credential: DNP CPNP-PC
Phone: 717-824-6142