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General NPI Number Information
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NPI Number | 1184738692
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Entity Type | Organization
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Legal Business Name | COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 1 TAYLOR AVE STE 4
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City | PEARISBURG
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State | VA
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Zip | 24134-2079
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Country | US
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Telephone | 540-921-2891
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Fax | 540-921-1335
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Provider Business Mailing Address
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Address Line | 1 TAYLOR AVE STE 4
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City | PEARISBURG
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State | VA
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Zip | 24134-2079
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Country | US
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Telephone | 540-921-2891
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Fax | 540-921-1335
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | NOELLE BISSELL
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Credential | MD
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Telephone | 540-381-7100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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