Organization
HEALTH PRO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER M. MOORE (MANAGING MEMBER)
(540) 777-1011
Entity
Organization
Contact information
Practice address
3959 ELECTRIC RD, SUITE 400, ROANOKE, VA 24018-4562
(540) 777-1011
(540) 777-1004
Mailing address
3959 ELECTRIC RD, SUITE 400, ROANOKE, VA 24018-4562
(540) 777-1011
(540) 777-1004
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
BUS. LICENSE #22659
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0236079
ANTHEM BC/BS
VA
Enumeration date
06/29/2006
Last updated
08/22/2020
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