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	:	1700444775
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	:	603-718-3824

Provider Business Practice Location Address
First Line	:	2912 W 6TH ST STE 120
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76107-3349
Country	:	US
Telephone Number	:	817-717-2854
Fax Number	:	817-717-6226

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

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	09/27/2022

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Directions to “VIRTIS HEALTH, LLC ” Practice Location

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