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Organization

VIRGINIA DEPARTMENT OF HEALTH

Active
Other names
Dickenson County Health Department
Organization subpart
No

Provider details

NPI number
Authorized official
JOHNNY WILLIS (BUSINESS MANAGER)
(276) 926-4979
Entity
Organization

Contact information

Practice address
334 BRUSH CREEK ROAD, CLINTWOOD, VA 24228-0768
(276) 926-4979
(276) 926-4426
Mailing address
PO BOX 768, CLINTWOOD, VA 24228-0768
(276) 926-4979
(276) 926-4426

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
370009593
RAILROAD MEDICARE
VA
Enumeration date
03/28/2006
Last updated
06/10/2011
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