1598901977 NPI number — SPECIAL EVENT PROVIDERS OF EMERGENCY MEDICINE, INC.

Table of content: (NPI 1598901977)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598901977 NPI number — SPECIAL EVENT PROVIDERS OF EMERGENCY MEDICINE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECIAL EVENT PROVIDERS OF EMERGENCY MEDICINE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598901977
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 68580
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23471-8580
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-737-2429
Provider Business Mailing Address Fax Number:
757-588-3754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1621 DONNA DR
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23451-6105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-422-4898
Provider Business Practice Location Address Fax Number:
757-422-5707
Provider Enumeration Date:
01/06/2009

Additional Information

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
757-737-2429

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  2096EV , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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