| NPI Details | |
|---|---|
| NPI | 1053386979 |
| Enumeration Date | 02/22/2006 |
| Last Updated | 06/09/2011 |
| Entity Type | Healthcare Provider |
| Active | Over 12 years ago |
| Authorized Information | |
|---|---|
| Name | ANGELA YVETTE ANGELA |
| Position | BUSINESS MANAGER |
| Phone | (757) 653-3040 |
| Fax | (757) 653-0834 |
| Practice Location | |
|---|---|
| 26022 ADMINISTRATIVE CENTER DRIVE COURTLAND VA, 23837-0009, US |
|
| Phone | (757) 653-3040 |
| Fax | (757) 653-0834 |
| Business Location | |
|---|---|
| 26022 ADMINISTRATIVE CENTER DRIVE PO BOX 09 COURTLAND VA, 23837-0009, US |
|
| Phone | (757) 653-3040 |
| Fax | (757) 653-0834 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 261QP0905X |
| License State | |
| License Number | |
| Remove 1053386979 NPI Number | |
According to our database, Commonwealth Of Virginia State Board Of Health NPI is 1053386979, taxonomy code is 261QP0905X Commonwealth Of Virginia State Board Of Health physically located at 26022 Administrative Center Drive, Courtland VA, 23837-0009. NPI Number 1033115704 has the healthcare provider type.
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1053386979 NPI number is provided on an as is basis without warranty of any kind. 1053386979 is maintained by the National Plan & Provider Enumeration System. The contents of Commonwealth Of Virginia State Board Of Health are for informational purposes only.
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