Provider Demographics
NPI:1376254870
Name:VIRTUAL LOGIX LLC
Entity Type:Organization
Organization Name:VIRTUAL LOGIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:SUCHMA
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-289-5301
Mailing Address - Street 1:3912 ASHFORD TRL NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1897
Mailing Address - Country:US
Mailing Address - Phone:609-289-5301
Mailing Address - Fax:609-939-0539
Practice Address - Street 1:708 KINGSTON CT
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-2429
Practice Address - Country:US
Practice Address - Phone:609-289-5301
Practice Address - Fax:609-939-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty