Tidewater Kidney Specialists, Inc.
LBN: Tidewater Kidney Specialists, Inc.
Tidewater Kidney Specialists, Inc. is an health care organization with primary practice located at 4445 Corporation Ln Ste 100 , Virginia Beach VA 23462-3666. The organization recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is the primary health care specialty.
Tidewater Kidney Specialists, Inc. can be contacted via phone (757) 623-0005, or through Skidmore, Elizabeth via phone (757) 623-0005.
Contact Information
Primary practice address
4445 Corporation Ln Ste 100
Virginia Beach VA 23462-3666
Phone: (757) 623-0005
Fax: (757) 548-1129
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | Virginia | |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | Virginia |
Profile Details
| NPI number | 1780624627 |
|---|---|
| LBN Legal business name | Tidewater Kidney Specialists, Inc. |
| DBA Doing business as | |
| Authorized official | Skidmore, Elizabeth |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Jan 20th, 2022 - about 2 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780624627 | NPPES |
| North Carolina | MEDICAID | 890129J |
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