Provider Demographics
NPI:1003369653
Name:VIRTUOUS MARIE LLC
Entity Type:Organization
Organization Name:VIRTUOUS MARIE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DELYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-770-3162
Mailing Address - Street 1:322 N SHORE DR
Mailing Address - Street 2:200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5870
Mailing Address - Country:US
Mailing Address - Phone:412-770-3162
Mailing Address - Fax:412-770-3101
Practice Address - Street 1:322 N SHORE DR
Practice Address - Street 2:200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5870
Practice Address - Country:US
Practice Address - Phone:412-770-3162
Practice Address - Fax:412-770-3101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-01
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA28523601251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2852OtherMEDICARE