Commonwealth of Virginia State Board of Health

Organization Active NPI Public Health or Welfare Agency · Leesburg, VA

NPI 1457450421 · NPPES record last updated Feb 6, 2017

Key facts

NPI
1457450421
Entity type
Organization (NPI type 2)
Primary specialty
Public Health or Welfare Agency 251K00000X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Practice address
102 Heritage Way NE
1St Floor Suite #100
Leesburg, VA 20176
Phone
(703) 771-5830
Fax
(703) 771-5550
NPI assigned
Sep 22, 2006
Organization subpart
No

Authorized official

Name
Dr. David Goodfriend, MD
Title
Director
Phone
(703) 771-5829

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Commonwealth of VA State (163 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Yes

Addresses

Primary practice location

102 Heritage Way NE
1St Floor Suite #100
Leesburg, VA 20176

Mailing address

PO Box 7000- MSC #68
Leesburg, VA 20177-7000
Phone (703) 771-5830

Other identifiers

IdentifierTypeStateIssuer
0013769MedicaidVA

Other names

  • Loudoun County Health Department-Dental Clinic Doing business as

Other providers in Leesburg, VA

All providers in Leesburg, VA · Public Health or Welfare Agency in Virginia

Sources for this page

Verify at the official NPI Registry.