COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH; NPI #1053386979

Contact Information

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

26022 ADMINISTRATIVE CENTER DRIVE
COURTLAND, VA 23837-0009

Phone: 757-653-3040
Fax: 757-653-0834
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Public Health, State or Local	261QP0905X

Indicates primary specialty

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

NPI Number 1053386979

LBN Legal business name COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

Authorized official ANGELA TILLERY - (BUSINESS MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 02/22/2006

Last updated 06/09/2011 - About 15 years ago

Identifiers

VA	Medicaid	008700681
VA	Medicaid	008770280
VA	Medicaid	497229
VA	Medicaid	4975952
VA	Medicaid	8450714

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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