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Organization

SOUTHERN DOMINION HEALTH SYSTEM, INC.

Active
Parent organization
SOUTHERN DOMINION HEALTH SYSTEM, INC.
Other names
Dinwiddie Medical Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHERN DOMINION HEALTH SYSTEM, INC.
Authorized official
APRIL KING (CEO)
(434) 696-2165
Entity
Organization

Contact information

Practice address
13855 COURTHOUSE RD, DINWIDDIE, VA 23841-2254
(804) 469-3731
(804) 469-5307
Mailing address
PO BOX 70, VICTORIA, VA 23974-0070
(434) 696-2165
(434) 696-1378

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
VA
261QF0400X
Federally Qualified Health Center (FQHC)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007604025
VA
Enumeration date
05/08/2007
Last updated
02/07/2024
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