Healthcare Provider Details

I. General information

NPI: 1215845052
Provider Name (Legal Business Name): BRIDGEHAVEN MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 COMMONWEALTH PL STE 210
VIRGINIA BEACH VA
23464-4528
US

IV. Provider business mailing address

900 COMMONWEALTH PL STE 210
VIRGINIA BEACH VA
23464-4528
US

V. Phone/Fax

Practice location:
  • Phone: 757-734-7155
  • Fax:
Mailing address:
  • Phone: 757-734-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL

VIII. Authorized Official

Name: TIFFANY JOHNSON
Title or Position: CO-OWNER
Credential:
Phone: 757-734-7155