Commonwealth of Virginia State Board of Health
Organization Active NPI Public Health or Welfare Agency · Nottoway, VA
NPI 1902902612 · NPPES record last updated Sep 20, 2010
Key facts
- NPI
- 1902902612
- 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
- 207 West Courthouse Rd.
Nottoway, VA 23955-0027 - Phone
- (434) 645-7595
- Fax
- (434) 645-8197
- NPI assigned
- Sep 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Alexander P Samuel, M.D.
- Title
- District Health Director
- Phone
- (434) 392-3982
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031117000414 | VA | Part B Supplier - Public Health/Welfare Agency | 0547174369 |
Receives reassigned benefits from 6 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Commonwealth of VA State
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
207 West Courthouse Rd.
Nottoway, VA 23955-0027
Mailing address
PO Box 27
Nottoway, VA 23955-0027
Phone (434) 645-7595
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600000142 | Other | VA | RAILROAD MEDICARE PART B |
| 004975791 | Medicaid | VA |
Other names
- Nottoway County Health Department
Other providers in Nottoway, VA
All providers in Nottoway, VA · Public Health or Welfare Agency in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.