COMMONWEALTH OF VIRGINIA/STATE BOARD OF HEALTH; NPI #1083611107

Contact Information

COMMONWEALTH OF VIRGINIA/STATE BOARD OF HEALTH

836 J CLYDE MORRIS BLVD
NEWPORT NEWS, VA 23601-1303

Phone: 757-594-7305
Fax: 757-594-7714
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 1083611107

LBN Legal business name COMMONWEALTH OF VIRGINIA/STATE BOARD OF HEALTH

Authorized official NATASHA DWAMENA - (HEALTH DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/05/2005

Last updated 11/09/2023 - About 3 years ago

Identifiers

VA	License #	00240339042
VA	Medicaid	4975103
VA	Other	P00245240	PALMETTO GBA-MEDICARE

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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