Provider Demographics
NPI:1174147193
Name:VIRTU30 TELEHEALTH SERVICES CORP
Entity type:Organization
Organization Name:VIRTU30 TELEHEALTH SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
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:317-697-9296
Mailing Address - Fax:
Practice Address - Street 1:6436 S JOHN BUTLER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-9437
Practice Address - Country:US
Practice Address - Phone:877-298-2079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty