NPI 1104923895

Tidewater Medical Supply, INC

Organisation Oxygen Equipment & Supplies (DME) Chesapeake, VA

Practice location

Address: 525 Byron St Suite a, Chesapeake, VA 23320-7967
Phone: (757) 548-9999
Fax: (757) 549-7752

Authorised official

Name: Keith Anthony Davies
Title: President
Phone: (757) 548-9999

Registered specialties

Oxygen Equipment & Supplies (DME) Primary

Suppliers Taxonomy 332BX2000X Licence 0206009115 (VA)

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Registry record

NPI: 1104923895
Entity type: Organization
NPI issued: 17 Sep 2006
Record last updated: 11 Mar 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.