Southern Dominion Health System, Inc. is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Amelia Court House, Virginia. The current practice location for Southern Dominion Health System, Inc. is 8920 Otterburn Rd, Amelia Court House, Virginia. For appointments, you can reach them via phone at
(804) 561-5150. The mailing address for Southern Dominion Health System, Inc. is Po Box 70, Victoria, Virginia and phone number is (434) 696-2165.
Southern Dominion Health System, Inc. is licensed to practice in Virginia (license number ). The clinic also participates in the medicare program and its
NPI number is 1700099512. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(804) 561-5150.
Primary Care Clinic Profile
| Full Name | Southern Dominion Health System, Inc. |
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| Speciality | Clinic/Center |
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| Location | 8920 Otterburn Rd, Amelia Court House, Virginia |
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| Authorized Official Name and Position | April King (CEO) |
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| Authorized Official Contact | 4346962165 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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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 Details:
| NPI Number | 1700099512 |
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| Provider Enumeration Date | 05/08/2007 |
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| Last Update Date | 02/07/2024 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 0648188755 |
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| Medicare Enrollment ID | O20050516000658 |
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Medical Identifiers
Medical identifiers for Southern Dominion Health System, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700099512 | NPI | - | NPPES |
| 010192862 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Virginia) | Primary |
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