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General NPI Number Information
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NPI Number | 1407818701
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Entity Type | Organization
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Legal Business Name | COMMONWEATLH OF VIRGINIA STATE BOARD OF HEALTH
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 423 N. CHURCH ROAD
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-0206
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Country | US
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Telephone | 804-758-2381
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Fax | 804-758-4828
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-0206
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Country | US
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Telephone | 804-758-2381
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Fax | 804-758-4828
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. SHERRY HOUSE
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Credential |
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Telephone | 804-758-2381
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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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