Provider Demographics
NPI:1942479365
Name:SOUTHLAND HEALTH SERVICES OF VIRGINIA, INC.
Entity Type:Organization
Organization Name:SOUTHLAND HEALTH SERVICES OF VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-247-9560
Mailing Address - Street 1:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:AL
Mailing Address - Zip Code:35592-1497
Mailing Address - Country:US
Mailing Address - Phone:205-695-9800
Mailing Address - Fax:205-695-7677
Practice Address - Street 1:201 VIRGINIA AVENUE NE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273
Practice Address - Country:US
Practice Address - Phone:276-679-4711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport