1154338390 NPI number — VALLEY REGIONAL HOSPITAL, INC.

Table of content: (NPI 1154338390)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154338390 NPI number — VALLEY REGIONAL HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY REGIONAL HOSPITAL, 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:
ASSOCIATES IN MEDICINE
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:
1154338390
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
243 ELM STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLAREMONT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03743-2099
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-542-7771
Provider Business Mailing Address Fax Number:
603-543-6950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 ELM STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAREMONT
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03743-2099
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-543-6900
Provider Business Practice Location Address Fax Number:
603-542-9497
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SHAW
Authorized Official First Name:
JEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
603-542-7771

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RE0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 3073676 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 27101 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 55932 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: ASSO114198 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: VALL00048236 . This is a "VTBCBS" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 0004198 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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