Organization · Type 2 NPI

Commonwealth of Virginia State Board of Health

State or Local Public Health Clinic/Center · Bristol, VA

NPI number 1114015716 Active

Practice location

15068 Lee Hwy, Suite 900
Bristol, VA 24202-4263

Fax (276) 645-4913

Specialties and licenses

Taxonomy	Code	License
State or Local Public Health Clinic/Center Primary	261QP0905X	None listed

State or Local Public Health Clinic/Center: Definition to come...

NPI record

NPI: 1114015716
Entity type: Organization (Type 2)
Issued: Oct 10, 2006
Last updated: Jan 26, 2016
Status: Active
Subpart: Yes of Commonwealth of Virginia State BD of Health

Other names

<unavail>
Southwest Virginia Care Connection for Children · doing business as

Authorized official

Vanessa Walker-Harris, MD
Director of Office of Family Health
(804) 864-7170

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1114015716

Commonwealth of Virginia State Board of Health's National Provider Identifier is 1114015716, issued on Oct 10, 2006. The primary taxonomy on file is State or Local Public Health Clinic/Center (261QP0905X), and the practice location is in Bristol, VA. The record was last updated on Jan 26, 2016.