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General NPI Number Information
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NPI Number | 1861361172
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Entity Type | Organization
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Legal Business Name | SOUTHERN DOMINION HEALTH SYSTEM INC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 1807 MAIN STREET
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City | VICTORIA
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State | VA
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Zip | 23974
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Country | US
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Telephone | 434-696-2165
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Fax | 434-696-1557
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | VICTORIA
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State | VA
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Zip | 23974-0070
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Country | US
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Telephone | 434-696-2165
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Fax | 434-696-1557
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Authorized Official
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Title or Position | CEO
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Name | APRIL KING
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Credential |
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Telephone | 434-696-2165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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