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General NPI Number Information
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NPI Number | 1669567632
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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 | 10/04/2006
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Last Update Date | 10/06/2010
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Provider Practice Location Address
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Address Line | 7114 LANKFORD HIGHWAY
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City | NASSAWADOX
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State | VA
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Zip | 23413
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Country | US
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Telephone | 757-442-6228
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Fax | 757-442-4307
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Provider Business Mailing Address
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Address Line | PO BOX 248
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City | NASSAWADOX
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State | VA
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Zip | 23413-0248
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Country | US
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Telephone | 757-442-6228
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Fax | 757-442-4307
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Authorized Official
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Title or Position | ADMINISTRATIVE MANAGER
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Name | MR. SCOTT CHANDLER
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Credential |
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Telephone | 757-442-6228
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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 | VA
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