Provider Demographics
NPI:1104512979
Name:VIRTU30 TELEHEALTH SERVICES CORP
Entity type:Organization
Organization Name:VIRTU30 TELEHEALTH SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:317-697-9296
Mailing Address - Street 1:1540 16TH ST NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-3447
Mailing Address - Country:US
Mailing Address - Phone:239-877-2982
Mailing Address - Fax:
Practice Address - Street 1:1540 16TH ST NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-3447
Practice Address - Country:US
Practice Address - Phone:877-298-2076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRTU30 TELEHEALTH SERVICES CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-14
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty