Provider Demographics
NPI:1164286761
Name:VIRTARE HEALTH PHYSICIANS SERVICES OF UTAH, PLLC
Entity Type:Organization
Organization Name:VIRTARE HEALTH PHYSICIANS SERVICES OF UTAH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTTA ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODA
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MBA
Authorized Official - Phone:240-334-7778
Mailing Address - Street 1:10890 THORNMINT RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2402
Mailing Address - Country:US
Mailing Address - Phone:240-334-7338
Mailing Address - Fax:
Practice Address - Street 1:4001 S 700 E STE 500
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2523
Practice Address - Country:US
Practice Address - Phone:855-745-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty