| NPI | 1699011312 |
|---|---|
| Former Legal Business Name | TIDEWATER MEDICAL TRANSPORT LLC |
| Entity Type | Organization |
| Authorized Contact | BARBARA DAWN SMITH President Owner 757-399-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 341600000X Ambulance (Licence: VA 0786425-9) |
| Additional Taxonomies | 3416L0300X Ambulance Land Transport |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2019-06-26 |