Organization
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Active
Other names
Isle of Wight Health Department
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA YVETTE TILLERY (BUSINESS MANAGER)
(757) 514-4765
Entity
Organization
Contact information
Practice address
919 S CHURCH ST, SMITHFIELD, VA 23430-1715
(757) 357-4177
(757) 357-2838
Mailing address
919 S CHURCH ST, SMITHFIELD, VA 23430-1715
(757) 357-4177
(757) 357-2838
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008700656
PERSONAL CARE
VA
05
—
008770310
—
VA
01
—
4975618
CLINIC
—
05
—
8450811
—
VA
Enumeration date
02/22/2006
Last updated
05/23/2011
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