Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
King George Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROOKE W ROSSHEIM M.D., M.P.H (DIRECTOR)
(540) 899-4797
Entity
Organization
Contact information
Practice address
10079 KINGS HIGHWAY, KING GEORGE, VA 22485-3445
(540) 775-3111
(540) 775-3109
Mailing address
608 JACKSON STREET, FREDERICKSBURG, VA 22401-5719
(540) 899-4797
(540) 899-4599
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
VA
251K00000X
Public Health or Welfare Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000030996
MEDICAID-SLH
VA
01
—
004975634
VIRGINIA PREMIER
VA
05
—
004975634
—
VA
01
—
266520
ANTHEM HK
VA
01
—
418740
SOUTHERN HEALTH
VA
01
—
P00193783
MEDICARE-R/R
VA
Enumeration date
06/16/2006
Last updated
06/13/2011
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