Basic Information
Provider Information
NPI: 1992055719
EntityType: 2
ReplacementNPI:  
OrganizationName: VERUS HEALTHCARE, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1569 MALLORY LANE
Address2: BUILDING 100
City: BRENTWOOD
State: TN
PostalCode: 37027
CountryCode: US
TelephoneNumber: 8004875566
FaxNumber:  
Practice Location
Address1: 4211 MEDICAL PKWY STE B
Address2:  
City: AUSTIN
State: TX
PostalCode: 78756
CountryCode: US
TelephoneNumber: 8004875566
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/19/2012
LastUpdateDate: 09/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GRIGGS
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 4072060040
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: VERUS HEALTHCARE, INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


Home