| Southern Dominion Health System, Inc. | |
|
1508 K-v Road Victoria VA 23974 | |
| (434) 696-2165 | |
| (434) 696-1378 |
| Full Name | Southern Dominion Health System, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1508 K-v Road, Victoria, 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. 1508 K-v Road Victoria VA 23974 Ph: (434) 696-2165 |
| NPI Number | 1497969091 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 02/07/2024 |
| Medicare PECOS PAC ID | 0648188755 |
|---|---|
| Medicare Enrollment ID | O20080520000768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497969091 | NPI | - | NPPES |
| 007691084 | Medicaid | VA |
Southern Dominion Health System, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1508 K V Rd, Victoria, VA 23974 Phone: 434-696-2165 Fax: 434-696-1378 | |
Southern Dominion Health System, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1418 6th Street, Victoria, VA 23974 Phone: 434-696-4180 Fax: 434-696-4182 | |
Southern Dominion Health System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1508 K V Road, Victoria, VA 23974 Phone: 434-696-2165 Fax: 434-696-1557 |