1528054681 NPI number — VALLEY REGIONAL ENTERPRISES INC

Table of content: (NPI 1528054681)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528054681 NPI number — VALLEY REGIONAL ENTERPRISES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY REGIONAL ENTERPRISES 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 MEDICAL TRANSPORT
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:
1528054681
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1910
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22604-8060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-536-5229
Provider Business Mailing Address Fax Number:
540-536-4359

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 FRONT ROYAL PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22602-7319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-536-2741
Provider Business Practice Location Address Fax Number:
540-722-3160
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HEISEY
Authorized Official First Name:
M
Authorized Official Middle Name:
FRANK
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
540-536-5260

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 094401 . This is a "BS TRIGO MEDIGAP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000223076 . This is a "BS M T STATE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 324118100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1385406 . This is a "UMWA" identifier . This identifiers is of the category "OTHER".
  • Identifier: AM8453410101 . This is a "BS MARYLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0144683000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080196300 . This is a "FED BLACK LUNG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 541566064 . This is a "CHIR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0144683001 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2122943 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9014403 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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