National Provider Identifier Database

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Public Health or Welfare


Contact Information

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
102 HERITAGE WAY NE
1ST FLOOR SUITE #100
LEESBURG, VA20176
Phone: 703-777-0236
Fax: 703-771-5393
Website:
Specialty Taxonomy Code
* Public Health or Welfare 251K00000X

* Indicates primary specialty

NPI Profile & details for COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

NPI Number 1154428605
Legal business name
LBN
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Authorized official DAVID GOODFRIEND - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 09/19/2006
Last updated 07/21/2011 - About 15 years ago
Sole proprietor1 Not specified
Identifiers
  • VA Medicaid: 004975677

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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