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Contact Information

DOMINION HEALTH MEDICAL ASSOC
2232 WILBORN AVE
SUITE F
SOUTH BOSTON, VA24592
 Phone: 434-517-8095
 Fax: 434-517-3887
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for DOMINION HEALTH MEDICAL ASSOC

NPI Number 1427306315
LBN Legal business name DOMINION HEALTH MEDICAL ASSOC
Authorized official CECIL HAZELWOOD - (MANAGER/SDHG)
Entity Organization
Organization subpart 1 No
Enumeration date 08/27/2012
Last updated 02/10/2015 - About 11 years ago
Identifiers
VA Other 0101251391 VIRGINIA LICENSE
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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