| Southern Dominion Health System, Inc. | |
|
1418 6th Street Victoria VA 23974 | |
| (434) 696-4180 | |
| (434) 696-4182 |
| Full Name | Southern Dominion Health System, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1418 6th Street, Victoria, Virginia |
| Authorized Official Name and Position | April King (CEO) |
| 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. 1418 6th Street Victoria VA 23974 Ph: (434) 696-4180 |
| NPI Number | 1396995940 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 02/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396995940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Virginia) | Primary |
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: 1508 K V Road, Victoria, VA 23974 Phone: 434-696-2165 Fax: 434-696-1557 | |
Southern Dominion Health System, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1508 K-v Road, Victoria, VA 23974 Phone: 434-696-2165 Fax: 434-696-1378 |