MEDICARE: DEPARTMENT OF HEALTH GOVT OF THE VIRGIN ISLANDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency		VI

General Provider Information

NPI Number	:	1396072716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEPARTMENT OF HEALTH GOVT OF THE VIRGIN ISLANDS

Provider Business Mailing Address
First Line	:	3500 ESTATE RICHMOND
Second Line	:	CHARLES HARWOOD COMPLEX
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4370
Country	:	US
Telephone Number	:	340-773-1311
Fax Number	:	340-773-1376

Provider Business Practice Location Address
First Line	:	3500 ESTATE RICHMOND
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00820-4370
Country	:	US
Telephone Number	:	340-773-1311
Fax Number	:	340-773-1376

Authorized Official
Title or Position	:	COMMISSIONER
Name	:	JULIA SHEEN
Credential	:	MPH
Telephone Number	:	340-773-1311

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	11/05/2009

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Directions to “DEPARTMENT OF HEALTH GOVT OF THE VIRGIN ISLANDS ” Practice Location

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