Provider Demographics
NPI:1003021502
Name:US NAVY
Entity Type:Organization
Organization Name:US NAVY
Other - Org Name:MOBILE DIVING & SALVAGE UNIT - TWO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INDEPENDENT DUTY CORPSMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:IDC
Authorized Official - Phone:757-462-3178
Mailing Address - Street 1:5972 BEECHWALK DRIVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:VA
Mailing Address - Zip Code:23464
Mailing Address - Country:US
Mailing Address - Phone:850-774-5768
Mailing Address - Fax:
Practice Address - Street 1:5972 BEECHWALK DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4917
Practice Address - Country:US
Practice Address - Phone:850-774-5768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response AttendantGroup - Multi-Specialty