Tidewater Medical Supply, Inc
LBN: Tidewater Medical Supply, Inc
Tidewater Medical Supply, Inc is an health care organization with primary practice located at 525 Byron St Suite A, Chesapeake VA 23320-7967. The organization recently has only one registered license in Suppliers / Oxygen Equipment & Supplies, which is considered as the primary health care specialty.
Tidewater Medical Supply, Inc can be contacted via phone (757) 548-9999, or through Davies, Keith Anthony via phone (757) 548-9999.
Contact Information
Primary practice address
525 Byron St Suite A
Chesapeake VA 23320-7967
Phone: (757) 548-9999
Fax: (757) 549-7752
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Oxygen Equipment & Supplies | 332BX2000X | 0206009115 | Virginia |
Profile Details
| NPI number | 1104923895 |
|---|---|
| LBN Legal business name | Tidewater Medical Supply, Inc |
| DBA Doing business as | |
| Authorized official | Davies, Keith Anthony |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 17th, 2006 |
| Last updated | Mar 11th, 2010 - about 15 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 | 1104923895 | NPPES |
| Virginia | Other | 1258980001 | MEDICARE PARTICIPATING PROVIDER ID # 1258980001 STATE VA PTAN # |
| Virginia | MEDICAID | 009117920 | MEDICARE PARTICIPATING PROVIDER ID # 1258980001 STATE VA PTAN # |
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