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General NPI Number Information
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NPI Number | 1275669277
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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 | 02/26/2007
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 4480 KING ST SUITE 413
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1300
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Country | US
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Telephone | 703-746-4967
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Fax | 703-746-4930
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Provider Business Mailing Address
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Address Line | 4480 KING ST SUITE 413
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1300
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Country | US
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Telephone | 703-746-4967
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Fax | 703-746-4930
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JEFFREY R LEVINE
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Credential |
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Telephone | 703-746-4967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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