| Southampton County Health Department | |
|
26022 Administrative Center Drive Courtland VA 23837-0009 | |
| (757) 653-3040 | |
| (757) 653-0834 |
| Full Name | Southampton County Health Department |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 26022 Administrative Center Drive, Courtland, Virginia |
| Authorized Official Name and Position | Angela Yvette Tillery (BUSINESS MANAGER) |
| Authorized Official Contact | 7575144765 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southampton County Health Department 26022 Administrative Center Drive Po Box 09 Courtland VA 23837-0009 Ph: (757) 653-3040 | Southampton County Health Department 26022 Administrative Center Drive Courtland VA 23837-0009 Ph: (757) 653-3040 |
| NPI Number | 1053386979 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 06/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053386979 | NPI | - | NPPES |
| 8450714 | Medicaid | VA | |
| 008700681 | Medicaid | VA | |
| 008770280 | Medicaid | VA | |
| 497229 | Medicaid | VA | |
| 4975952 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |