Healthcare Provider Details

I. General information

NPI: 1679580922
Provider Name (Legal Business Name): COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4038 THOMAS NELSON HIGHWAY
ARRINGTON VA
22922
US

IV. Provider business mailing address

PO BOX 98
LOVINGSTON VA
22949-0098
US

V. Phone/Fax

Practice location:
  • Phone: 434-263-8315
  • Fax: 434-263-4304
Mailing address:
  • Phone: 434-263-8315
  • Fax: 434-263-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE E. BONDS
Title or Position: HEALTH DIRECTOR
Credential: M.D., MPH
Phone: 434-972-6219