1750333407 NPI number — VIRTUE HOME HEALTH, INC.

Table of content: (NPI 1750333407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750333407 NPI number — VIRTUE HOME HEALTH, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIRTUE HOME HEALTH, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MERIDA HEALTH CARE GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750333407
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78551-1230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-423-1197
Provider Business Mailing Address Fax Number:
956-440-1837

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4444 CORONA DR
Provider Second Line Business Practice Location Address:
STE. 212
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78411-4324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-853-2000
Provider Business Practice Location Address Fax Number:
361-853-2017
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MESQUIAS
Authorized Official First Name:
RODNEY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-423-1197

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  010359 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 214632601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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