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General NPI Number Information
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NPI Number | 1194176149
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Entity Type | Organization
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Legal Business Name | FIRST MERIDIAN MEDICAL LLC
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Dates
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Enumeration Date | 06/30/2016
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 229 CLEARFIELD AVE
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-1815
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Country | US
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Telephone | 757-671-1144
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Fax | 757-671-1265
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Provider Business Mailing Address
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Address Line | 1554 RIVER BIRCH RUN N
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City | CHESAPEAKE
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State | VA
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Zip | 23320-7500
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Country | US
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Telephone | 757-671-1144
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Fax | 757-965-4168
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. TRACEY MASON
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Credential |
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Telephone | 757-965-4151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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