Provider Demographics
NPI:1588802912
Name:TAMAR MINISTRIES
Entity Type:Organization
Organization Name:TAMAR MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:757-831-2968
Mailing Address - Street 1:801 BUTLER ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-3404
Mailing Address - Country:US
Mailing Address - Phone:757-831-2968
Mailing Address - Fax:757-436-5410
Practice Address - Street 1:801 BUTLER ST
Practice Address - Street 2:SUITE 20
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-3404
Practice Address - Country:US
Practice Address - Phone:757-831-2968
Practice Address - Fax:757-436-5410
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAMAR HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-22
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0150791694251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0150791694Medicaid