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Organization

SOUTHERN DOMINION HEALTH SYSTEM, INC.

Active
Parent organization
SOUTHERN DOMINION HEALTH SYSTEM, INC.
Other names
Amelia Life Care, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTHERN DOMINION HEALTH SYSTEM, INC.
Authorized official
MRS. JILL W. SEAMANS (CFO)
(434) 696-2165
Entity
Organization

Contact information

Practice address
8830 VIRGINIA STREET, AMELIA, VA 23002
(434) 696-2165
(434) 696-1557
Mailing address
PO BOX 70, VICTORIA, VA 23974-0070
(434) 696-2165
(434) 696-1557

Taxonomy

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

Other

Enumeration date
05/11/2012
Last updated
12/03/2015
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