Organization · Type 2 NPI

Commonwealth of Virginia State Board of Health

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

NPI number 1487629374 Active

Practice location

135 Hall Avenue, Suite A
Suffolk, VA 23434-4657

Call (757) 514-4700 Map

Fax (757) 514-4873

Mailing address

P.o. Box 1587, 135 Hall Avenue, Suite A
Suffolk, VA 23434-4657

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: 1487629374
Entity type: Organization (Type 2)
Issued: Feb 22, 2006
Last updated: Feb 9, 2010
Status: Active
Subpart: Yes of Commonwealth of Virginia State Board of Health

Other names

<unavail>
Suffolk Health Department · doing business as

Authorized official

Angela Yvette Tillery
Business Manager
(757) 514-4765

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 1487629374

Commonwealth of Virginia State Board of Health's National Provider Identifier is 1487629374, issued on Feb 22, 2006. The primary taxonomy on file is State or Local Public Health Clinic/Center (261QP0905X), and the practice location is in Suffolk, VA. The record was last updated on Feb 9, 2010.