Provider Demographics
NPI:1598901977
Name:SPECIAL EVENT PROVIDERS OF EMERGENCY MEDICINE, INC.
Entity Type:Organization
Organization Name:SPECIAL EVENT PROVIDERS OF EMERGENCY MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-737-2429
Mailing Address - Street 1:PO BOX 68580
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23471-8580
Mailing Address - Country:US
Mailing Address - Phone:757-737-2429
Mailing Address - Fax:757-588-3754
Practice Address - Street 1:1621 DONNA DR
Practice Address - Street 2:SUITE 3
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6105
Practice Address - Country:US
Practice Address - Phone:757-422-4898
Practice Address - Fax:757-422-5707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2096EV341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance