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General NPI Number Information
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NPI Number | 1437113297
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Entity Type | Organization
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Legal Business Name | VIRTUE MEDICAL SUPPLY COMPANY,LLC
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4889 SINCLAIR RD
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City | COLUMBUS
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State | OH
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Zip | 43229-5432
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Country | US
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Telephone | 614-888-8825
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Fax | 614-888-8831
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Provider Business Mailing Address
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Address Line | 4889 SINCLAIR RD
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City | COLUMBUS
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State | OH
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Zip | 43229-5433
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Country | US
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Telephone | 614-888-8825
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Fax | 614-888-8831
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Authorized Official
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Title or Position | EXECUTIVE DIRECTIVE
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Name | MS. SABATHA BEATRICE UMOETTE
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Credential | DME PROVIDER/SUPPLIE
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Telephone | 614-888-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 25299363
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License Number State | OH
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