MEDICARE: COMMONWEALTH OF VA STATE BOARD OF HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	600000206	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588647135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONWEALTH OF VA STATE BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 1159
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-1159
Country	:	US
Telephone Number	:	434-432-7232
Fax Number	:	434-432-7235

Provider Business Practice Location Address
First Line	:	200 H G MC GHEE DR
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531
Country	:	US
Telephone Number	:	434-432-7232
Fax Number	:	434-432-7235

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SCOTT J SPILLMANN
Credential	:	MD, MPH
Telephone Number	:	434-766-9800

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	11/26/2019

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Directions to “COMMONWEALTH OF VA STATE BOARD OF HEALTH ” Practice Location

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