1528054681 NPI number — VALLEY REGIONAL ENTERPRISES INC

Table of Contents

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:
Provider Other Organization Name Type Code:
6
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:
06/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 CAMPUS BLVD STE 100
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:
22601-2896
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-536-2348
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 PROSPERITY DR STE 4
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:
22602-5401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-536-2348
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BARRETT
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
540-536-0551

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: 1385406 . This is a "UMWA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2122943 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0144683001 , 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: 094401 . This is a "BS TRIGO MEDIGAP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9014403 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0144683000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 541566064 . This is a "CHIR" identifier . This identifiers is of the category "OTHER".
  • Identifier: AM8453410101 . This is a "BS MARYLAND" 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".




Copyright © 2007-2025 www.npivalidator.com