Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Parent organization
COMMONWEALTH OF VIRGINIA STATE BD OF HEALTH
Other names
Southwest Virginia Care Connection for Children
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF VIRGINIA STATE BD OF HEALTH
Authorized official
VANESSA WALKER-HARRIS M.D. (DIRECTOR OF OFFICE OF FAMILY HEALTH)
(804) 864-7170
Entity
Organization
Contact information
Practice address
15068 LEE HWY, SUITE 900, BRISTOL, VA 24202-4263
(276) 645-4900
(276) 645-4913
Mailing address
15068 LEE HWY, SUITE 900, BRISTOL, VA 24202-4263
(276) 645-4900
(276) 645-4913
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004976550
—
VA
Enumeration date
10/10/2006
Last updated
01/26/2016
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