| Suffolk Health Department | |
|
135 Hall Avenue Suite A Suffolk VA 23434-4657 | |
| (757) 514-4700 | |
| (757) 514-4873 |
| Full Name | Suffolk Health Department |
|---|---|
| Speciality | Clinic/Center |
| Location | 135 Hall Avenue, Suffolk, Virginia |
| Authorized Official Name and Position | Angela Yvette Tillery (BUSINESS MANAGER) |
| Authorized Official Contact | 7575144765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk Health Department P.o. Box 1587 135 Hall Avenue, Suite A Suffolk VA 23434-4657 Ph: (757) 514-4700 | Suffolk Health Department 135 Hall Avenue Suite A Suffolk VA 23434-4657 Ph: (757) 514-4700 |
| NPI Number | 1487629374 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 02/09/2010 |
| Medicare PECOS PAC ID | 0547174369 |
|---|---|
| Medicare Enrollment ID | O20100216000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487629374 | NPI | - | NPPES |
| 008700664 | Medicaid | VA | |
| 4972279 | Medicaid | VA | |
| 4976240 | Medicaid | VA | |
| 008770271 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
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