Commonwealth of Virginia State Board of Health
Organization Active NPI Public Health or Welfare Agency · Lunenburg, VA
NPI 1992801609 · NPPES record last updated Mar 24, 2011
Key facts
- NPI
- 1992801609
- 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
- 11387 Courthouse Rd
Lunenburg, VA 23952-9999 - Phone
- (434) 696-2346
- Fax
- (434) 696-1271
- NPI assigned
- Sep 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Alexander P Samuel, M.D.
- Title
- District Health Director
- Phone
- (434) 392-3984
Corporate family (same tax ID) 12
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
11387 Courthouse Rd
Lunenburg, VA 23952-9999
Mailing address
11387 Courthouse Rd
Lunenburg, VA 23952-9999
Phone (434) 696-2346
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00870182 | Other | VA | MEDICARE RAILROAD |
| 004975693 | Medicaid | VA |
Other names
- Lunenburg County Health Department
Other providers in Lunenburg, VA
All providers in Lunenburg, 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 Mar 24, 2011. 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.