MEDICARE: TIDEWATER PATHOLOGY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1235417833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIDEWATER PATHOLOGY INC

Provider Business Mailing Address
First Line	:	PO BOX 640
Second Line	:
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-0640
Country	:	US
Telephone Number	:	973-751-7515
Fax Number	:	973-751-1394

Provider Business Practice Location Address
First Line	:	924 EASTERN SHORE RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-3504
Country	:	US
Telephone Number	:	757-362-4051
Fax Number	:	757-425-1834

Authorized Official
Title or Position	:	OWNER
Name	:	SAVVAS E MENDRINOS
Credential	:	MD
Telephone Number	:	757-362-4051

Provider Enumeration Date	:	07/30/2011
Last Update Date	:	08/01/2011

Similar Medicare Providers

1801813522 — MS. JULIANA MICHELLE YIM LPN
Practice Location Address:

5339 PALMYRA CT
VIRGINIA BEACH, VA
23462-3504

Practice Phone: 757-572-5939
Practice Fax:

1205160132 — LAUREN ELIZABETH STANDEFER DDS
Practice Location Address:

2300 VIRGINIA PARKWAY
MCKINNEY, TX
75071-3504

Practice Phone: 972-542-8733
Practice Fax: 972-542-3905

1316375876 — LAUREN E. STANDEFER, DDS, PA
Practice Location Address:

2300 VIRGINIA PKWY
MCKINNEY, TX
75071-3504

Practice Phone: 372-542-8733
Practice Fax:

1174490775 — LEON DENTAL
Practice Location Address:

2300 VIRGINIA PKWY
MCKINNEY, TX
75071-3504

Practice Phone: 972-542-8733
Practice Fax:

1366437402 — DR. TIMOTHY HOLLISTER JONES MD
Practice Location Address:

6621 BAY LAUREL PL STE A
AVILA BEACH, CA
93424-3504

Practice Phone: 805-556-7006
Practice Fax: 805-439-1482

1821085002 — DR. ARTHUR A GOMBERG DO
Practice Location Address:

36 NE 2ND AVE
DEERFIELD BEACH, FL
33441-3504

Practice Phone: 954-421-0211
Practice Fax: 954-421-1289

Directions to “TIDEWATER PATHOLOGY INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.