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Organization

COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH

Active
Parent organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Other names
Hampton Health Department
Organization subpart
Yes

Provider details

NPI number
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Authorized official
DR. SAMUEL W BERG M.D., M.P.H. (DISTRICT DIRECTOR)
(757) 727-1172
Entity
Organization

Contact information

Practice address
3130 VICTORIA BLVD, HAMPTON, VA 23661-1544
(757) 727-1172
(757) 727-1185
Mailing address
3130 VICTORIA BLVD, HAMPTON, VA 23661-1544
(757) 727-1172
(757) 727-1185

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0036501
VA
05
004975014
VA
01
089265
ANTHEM PROVIDER NUMBER
VA
01
47211
SENTARA HEALTH PROVIDER #
VA
01
84962
VIRGINIA PREMIER PROVID #
VA
Enumeration date
03/08/2006
Last updated
09/19/2008
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