Organization
TSI TIDEWATER LLC
Active
Other names
Vital Care of Suffolk
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MCDONALD PHARMACISTS (MANAGING PHARMACISTS)
(757) 861-0050
Entity
Organization
Contact information
Practice address
1520 BREEZEPORT WAY STE 500, SUFFOLK, VA 23435-3757
(757) 861-0050
(757) 335-7354
Mailing address
1520 BREEZEPORT WAY STE 500, SUFFOLK, VA 23435-3757
(757) 861-0050
(757) 335-7354
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Enumeration date
01/11/2023
Last updated
05/12/2023
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