Provider Demographics
NPI:1437113297
Name:VIRTUE MEDICAL SUPPLY COMPANY,LLC
Entity Type:Organization
Organization Name:VIRTUE MEDICAL SUPPLY COMPANY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTIVE
Authorized Official - Prefix:MS
Authorized Official - First Name:SABATHA
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:UMOETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DME PROVIDER/SUPPLIE
Authorized Official - Phone:614-888-8825
Mailing Address - Street 1:4889 SINCLAIR RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-5433
Mailing Address - Country:US
Mailing Address - Phone:614-888-8825
Mailing Address - Fax:614-888-8831
Practice Address - Street 1:4889 SINCLAIR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-5432
Practice Address - Country:US
Practice Address - Phone:614-888-8825
Practice Address - Fax:614-888-8831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH25299363332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2440264Medicaid
OH4991950002Medicare NSC