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:
Map and Directions
Authorized official contact:
Name: Skidmore, Elizabeth
Phone: (757) 623-0005

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780624627 NPPES
North Carolina MEDICAID 890129J

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