Healthcare Provider Details

I. General information

NPI: 1114803061
Provider Name (Legal Business Name): VIRTUAL PREVENTIVE CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 LONG LN STE 3
UPPER DARBY PA
19082-3439
US

IV. Provider business mailing address

7018 SAYBROOK AVE
PHILADELPHIA PA
19142-1124
US

V. Phone/Fax

Practice location:
  • Phone: 215-847-7711
  • Fax:
Mailing address:
  • Phone: 215-847-7711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QP0002X
TaxonomyPhysician Nutrition Specialist (Family Medicine)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1002X
TaxonomyPhysician Nutrition Specialist (Internal Medicine)
License Number
License Number State

VIII. Authorized Official

Name: KATINA VIVIAN CARTER-GEIGER
Title or Position: CEO
Credential:
Phone: 484-661-2257