| Southern Dominion Health System, Inc. | |
|
8920 Otterburn Rd Amelia Court House VA 23002-4854 | |
| (804) 561-5150 | |
| (804) 561-6643 |
| Full Name | Southern Dominion Health System, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 8920 Otterburn Rd, Amelia Court House, Virginia |
| Authorized Official Name and Position | April King (CEO) |
| Authorized Official Contact | 4346962165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Dominion Health System, Inc. Po Box 70 Victoria VA 23974-0070 Ph: (434) 696-2165 | Southern Dominion Health System, Inc. 8920 Otterburn Rd Amelia Court House VA 23002-4854 Ph: (804) 561-5150 |
| NPI Number | 1700099512 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 02/07/2024 |
| Medicare PECOS PAC ID | 0648188755 |
|---|---|
| Medicare Enrollment ID | O20050516000658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700099512 | NPI | - | NPPES |
| 010192862 | Medicaid | VA |
Southern Dominion Health System Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8631 Namozine Rd, Amelia Court House, VA 23002 Phone: 804-561-6263 | |
At Home Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16520 Goodes Bridge Rd, Amelia Court House, VA 23002 Phone: 804-634-9270 Fax: 804-561-1757 |