1922290709 NPI number — VALLEY WOMEN'S HEALTH, P.C.

Table of content: (NPI 1922290709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922290709 NPI number — VALLEY WOMEN'S HEALTH, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY WOMEN'S HEALTH, P.C.
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:
Provider Other Organization Name Type Code:
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:
1922290709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1163 COUNTRY CLUB RD
Provider Second Line Business Mailing Address:
LOMBARDI CENTER STE. 101
Provider Business Mailing Address City Name:
MONONGAHELA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15063-1013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-258-2229
Provider Business Mailing Address Fax Number:
724-258-7641

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1163 COUNTRY CLUB RD
Provider Second Line Business Practice Location Address:
LOMBARDI CENTER STE. 101
Provider Business Practice Location Address City Name:
MONONGAHELA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15063-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-258-2229
Provider Business Practice Location Address Fax Number:
724-258-7641
Provider Enumeration Date:
08/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COX
Authorized Official First Name:
WALTER
Authorized Official Middle Name:
R
Authorized Official Title or Position:
STAFF PHYSICIAN
Authorized Official Telephone Number:
724-258-2229

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 116500 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: C13418 . This is a "PALMETTO GBA/RR-MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 740435 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100755879 003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".