Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Wise County Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELEANOR SUE CANTRELL M.D. (DIRECTOR)
(276) 328-8000
Entity
Organization
Contact information
Practice address
134 ROBERTS AVE SW, WISE, VA 24293-5800
(276) 328-8000
(276) 376-1020
Mailing address
134 ROBERTS AVE SW, WISE, VA 24293-5800
(276) 328-8000
(276) 376-1020
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004975049
—
VA
01
—
600000529
RAILROAD MEDICARE
VA
Enumeration date
08/30/2006
Last updated
06/14/2011
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