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General NPI Number Information
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NPI Number | 1851430821
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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 | 02/06/2007
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Last Update Date | 09/12/2013
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Provider Practice Location Address
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Address Line | 190 BEECH STREET STE 102
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City | GATE CITY
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State | VA
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Zip | 25251-3623
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Country | US
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Telephone | 276-386-1312
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Fax | 276-386-2116
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Provider Business Mailing Address
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Address Line | 190 BEECH ST STE 102
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City | GATE CITY
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State | VA
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Zip | 24251-3623
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Country | US
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Telephone | 276-386-1312
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Fax | 276-386-2116
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | ELEANOR S. CANTRELL
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Credential | MD
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Telephone | 276-328-8000
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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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