Organization
TIDEWATER EXPRESS TRANSPORTATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARIEL WALTON (CEO)
(757) 477-2680
Entity
Organization
Contact information
Practice address
2007 JEHU ST, SUFFOLK, VA 23435-3539
(757) 639-9174
Mailing address
2007 JEHU ST, SUFFOLK, VA 23435-3539
(757) 639-9174
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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