Provider Demographics
NPI:1013946763
Name:COMMONWEALTH OF VIRGINIA BOARD OF HEALTH
Entity Type:Organization
Organization Name:COMMONWEALTH OF VIRGINIA BOARD OF HEALTH
Other - Org Name:HOPEWELL HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DISTRICT HEALTH DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-863-1652
Mailing Address - Street 1:220 APPOMATTOX ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2804
Mailing Address - Country:US
Mailing Address - Phone:804-458-1297
Mailing Address - Fax:804-541-3023
Practice Address - Street 1:220 APPOMATTOX ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2804
Practice Address - Country:US
Practice Address - Phone:804-458-1297
Practice Address - Fax:804-541-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA266462OtherANTHEM
VA004976177Medicaid
VA42517OtherSOUTHERN HEALTH
VA45763OtherCARENET
VA41194OtherOPTIMA/SENTARA
85735OtherVIRGINIA PREMIER
VA41194OtherOPTIMA/SENTARA