Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Parent organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Other names
Suffolk Health Department
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Authorized official
ANGELA YVETTE TILLERY (BUSINESS MANAGER)
(757) 514-4765
Entity
Organization
Contact information
Practice address
135 HALL AVENUE, SUITE A, SUFFOLK, VA 23434-4657
(757) 514-4700
(757) 514-4873
Mailing address
P.O. BOX 1587, 135 HALL AVENUE, SUITE A, SUFFOLK, VA 23434-4657
(757) 514-4700
(757) 514-4873
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
—
008700664
—
VA
05
—
008770271
—
VA
05
—
4972279
—
VA
05
—
4976240
—
VA
Enumeration date
02/22/2006
Last updated
02/09/2010
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