Provider Demographics
NPI:1164012860
Name:PARAMEDICAL SERVICES OF VA INC
Entity Type:Organization
Organization Name:PARAMEDICAL SERVICES OF VA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:VICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-908-6304
Mailing Address - Street 1:144 BUSINESS PARK DR STE 208
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6527
Mailing Address - Country:US
Mailing Address - Phone:757-490-8630
Mailing Address - Fax:757-490-1582
Practice Address - Street 1:144 BUSINESS PARK DR STE 208
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6527
Practice Address - Country:US
Practice Address - Phone:757-490-8630
Practice Address - Fax:757-490-1582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service