Provider Demographics
NPI:1114803061
Name:VIRTUAL PREVENTIVE CARE SERVICES
Entity type:Organization
Organization Name:VIRTUAL PREVENTIVE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATINA
Authorized Official - Middle Name:VIVIAN
Authorized Official - Last Name:CARTER-GEIGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-661-2257
Mailing Address - Street 1:7018 SAYBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-1124
Mailing Address - Country:US
Mailing Address - Phone:215-847-7711
Mailing Address - Fax:
Practice Address - Street 1:160 LONG LN STE 3
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-3439
Practice Address - Country:US
Practice Address - Phone:215-847-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QP0002XAllopathic & Osteopathic PhysiciansFamily MedicinePhysician Nutrition Specialist Group - Multi-Specialty
No207RP1002XAllopathic & Osteopathic PhysiciansInternal MedicinePhysician Nutrition Specialist Group - Multi-Specialty