Provider Demographics
NPI:1316975402
Name:HEALTH PRO LLC
Entity type:Organization
Organization Name:HEALTH PRO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-777-1011
Mailing Address - Street 1:3959 ELECTRIC RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4562
Mailing Address - Country:US
Mailing Address - Phone:540-777-1011
Mailing Address - Fax:540-777-1004
Practice Address - Street 1:3959 ELECTRIC RD
Practice Address - Street 2:SUITE 400
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4562
Practice Address - Country:US
Practice Address - Phone:540-777-1011
Practice Address - Fax:540-777-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABUS. LICENSE #22659332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0236079OtherANTHEM BC/BS
VA4414930001Medicare NSC