MEDICARE: VIRTIS HEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QI0500X	Infusion Therapy Clinic/Center
2	363L00000X	Nurse Practitioner
3	363LF0000X	Family Nurse Practitioner
4	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1326756453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTIS HEALTH, LLC

Provider Business Mailing Address
First Line	:	2801 NETWORK BLVD STE 505
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-1895
Country	:	US
Telephone Number	:	833-765-3648
Fax Number	:

Provider Business Practice Location Address
First Line	:	3291 E WARM SPRINGS RD STE 300B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3184
Country	:	US
Telephone Number	:	702-906-0308
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	RONALD P LINDAHL
Credential	:
Telephone Number	:	833-765-3648

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	11/08/2022

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