SOUTHERN DOMINION HEALTH SYSTEM, INC.; NPI #1104069996

Contact Information

SOUTHERN DOMINION HEALTH SYSTEM, INC.

1508 K V RD
VICTORIA, VA 23974-2624

Phone: 434-696-2319
Fax: 434-696-2326
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Federally Qualified Health Center (FQHC)	261QF0400X	B4[14]	Federally Qualified Health Center
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center

Indicates primary specialty

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NPI Profile & details for SOUTHERN DOMINION HEALTH SYSTEM, INC.

NPI Number	`1104069996`
LBN Legal business name	SOUTHERN DOMINION HEALTH SYSTEM, INC.
Authorized official	APRIL KING - (CEO)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	04/09/2009
Last updated	02/07/2024 - About 2 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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