| Organization Name: | TIDEWATER MEDICAL TRANSPORT, INC. |
| NPI Number: | 1699011312 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARBARA DAWN SMITH (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 2503 Woodrow St Suite 8 Portsmouth |
| State: | VA US |
| Postal Code: | 237072124 |
| Phone Number: | 7573990999 |
| Fax Number: | 7573991999 |
| NPI Enumeration Date: | 12/27/2012 |
| NPI Last Update Date: | 04/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 341600000X |
| License Number: | 0786425-9 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |