Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Parent organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Other names
Mecklenburg County Health Department
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Authorized official
DR. SCOTT J SPILLMANN MD, MPH (SOUTHSIDE HEALTH DISTRICT)
(434) 738-6545
Entity
Organization
Contact information
Practice address
969 MADISON ST, BOYDTON, VA 23917
(434) 738-6545
(434) 738-6295
Mailing address
969 MADISON ST, BOYDTON, VA 23917-3418
(434) 738-6545
(434) 738-6295
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
1010243863
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004975723
—
VA
05
—
005840686
—
VA
01
—
266538
ANTHEM BCBS
VA
01
—
29006
OPTIMA
VA
05
—
4975723
—
VA
Enumeration date
05/15/2006
Last updated
06/25/2018
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