| Southern Dominion Health System, Inc. | |
|
13855 Courthouse Road Dinwiddie VA 23841 | |
| (804) 469-3731 | |
| (804) 469-5307 |
| Full Name | Southern Dominion Health System, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 13855 Courthouse Road, Dinwiddie, Virginia |
| Authorized Official Name and Position | Jill W Seamans (CFO) |
| Authorized Official Contact | 4346962165 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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. 13855 Courthouse Road Dinwiddie VA 23841 Ph: (804) 469-3731 |
| NPI Number | 1124310446 |
|---|---|
| Provider Enumeration Date | 05/04/2011 |
| Last Update Date | 02/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124310446 | NPI | - | NPPES |
Southern Dominion Health System, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13855 Courthouse Rd, Dinwiddie, VA 23841 Phone: 804-469-3731 Fax: 804-469-5307 |