1164604633 NPI number — VALLEY HEALTH SYSTEMS INC

Table of content: (NPI 1164604633)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164604633 NPI number — VALLEY HEALTH SYSTEMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY HEALTH SYSTEMS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VALLEY HEALTH PRESTERA RT 60
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164604633
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2585 3RD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25703-1642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-697-1396
Provider Business Mailing Address Fax Number:
304-697-2086

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3375 US ROUTE 60
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-399-7770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WEINBERGER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
304-525-3334

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3810012152 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100260970 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0073236 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0097847 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100225950 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com