Healthcare Provider Details

I. General information

NPI: 1528002235
Provider Name (Legal Business Name): COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 15 PINE STREET
HILLSVILLE VA
24343
US

IV. Provider business mailing address

605 15 PINE STREET
HILLSVILLE VA
24343
US

V. Phone/Fax

Practice location:
  • Phone: 276-730-3180
  • Fax: 276-730-3185
Mailing address:
  • Phone: 276-730-3180
  • Fax: 276-730-3185

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: ANNA H STEVENS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 276-781-7450