Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Southampton County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA YVETTE TILLERY (BUSINESS MANAGER)
(757) 514-4765
Entity
Organization
Contact information
Practice address
26022 ADMINISTRATIVE CENTER DRIVE, COURTLAND, VA 23837-0009
(757) 653-3040
(757) 653-0834
Mailing address
26022 ADMINISTRATIVE CENTER DRIVE, PO BOX 09, COURTLAND, VA 23837-0009
(757) 653-3040
(757) 653-0834
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008700681
—
VA
05
—
008770280
—
VA
05
—
497229
—
VA
05
—
4975952
—
VA
05
—
8450714
—
VA
Enumeration date
02/22/2006
Last updated
06/09/2011
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