COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH NPI 1053386979

NPI Information

  • NPI: 1053386979
  • Provider Name: COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
  • Classification: Clinic/Center - 261QP0905X
  • Specialization: Public Health, State or Local
  • Entity Type: Organization
  • Doing Business As: SOUTHAMPTON COUNTY HEALTH DEPARTMENT
  • Address: 26022 ADMINISTRATIVE CENTER DRIVE
    COURTLAND, VA
    ZIP 23837
  • Phone: (757) 653-3040

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NPI Details

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH is a public health and state or local clinic center in Courtland, VA. COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH NPI is 1053386979. The provider is registered as an organization entity type.
The provider Is Doing Business As Southampton County Health Department.

The provider's business location address is:

26022 ADMINISTRATIVE CENTER DRIVE
COURTLAND, VA
ZIP 23837-009
Phone: (757) 653-3040
Fax: (757) 653-0834

The provider's authorized official is Angela Yvette Tillery .
The authorized official title is Business Manager and has the following contact phone number (757) 514-4765.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)

The enumeration date for this NPI number is 2/22/2006 and was last updated on 6/9/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP0905XClinic/CenterPublic Health, State or LocalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1497229MEDICAIDVIRGINIA
2008770280MEDICAIDVIRGINIA
3008700681MEDICAIDVIRGINIA
4600000008MEDICARE ID-TYPE UNSPECIFIEDCLINIC
58450714MEDICAIDVIRGINIA
64975952MEDICAIDVIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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