Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Henrico Health Department - East
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CARLA P. BENNETT (BUSINESS MANAGER)
(804) 501-4953
Entity
Organization
Contact information
Practice address
3810 NINE MILE RD, HENRICO, VA 23223-4848
(804) 652-3186
(804) 501-4588
Mailing address
3810 NINE MILE RD, HENRICO, VA 23223-4848
(804) 652-3186
(804) 501-4588
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072212
ANTHEM
VA
05
—
10001587
—
VA
05
—
4975588
—
VA
05
—
68428
—
VA
Enumeration date
10/04/2006
Last updated
02/18/2011
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