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General NPI Number Information
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NPI Number | 1114803061
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Entity Type | Organization
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Legal Business Name | VIRTUAL PREVENTIVE CARE SERVICES
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 160 LONG LN STE 3
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City | UPPER DARBY
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State | PA
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Zip | 19082-3439
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Country | US
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Telephone | 215-847-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 7018 SAYBROOK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19142-1124
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Country | US
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Telephone | 215-847-7711
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATINA VIVIAN CARTER-GEIGER
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Credential |
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Telephone | 484-661-2257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1002X
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Taxonomy Name | Physician Nutrition Specialist (Internal Medicine)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QP0002X
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Taxonomy Name | Physician Nutrition Specialist (Family Medicine)
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License Number |
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License Number State |
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