Organization
TIDEWATER MEDICAL TRANSPORT, INC
Active
Other names
Tidewater Medical Transport LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA DAWN SMITH (PRESIDENT-OWNER)
(757) 399-0999
Entity
Organization
Contact information
Practice address
573 CHAUTAUQUA AVE, PORTSMOUTH, VA 23707-2103
(757) 399-0999
(757) 399-1999
Mailing address
573 CHAUTAUQUA AVE, PORTSMOUTH, VA 23707-2103
(757) 399-0999
(757) 399-1999
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0786425-9
VA
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01333
VIRGINIA OFFICE OF EMERGENCY MEDICAL SERVICES (VAOEMS)
VA
01
—
064756499
D-U-N-S #
VA
01
—
0786425-9
STATE CORPORATION COMMISSION
VA
05
—
1699011312
—
VA
01
—
705193
SWAM
VA
01
—
712R4
CAGE CODE
—
Enumeration date
12/27/2012
Last updated
01/21/2026
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