1104008481 NPI number — VALLEY HEALTH SYSTEMS INC

Table of content: (NPI 1104008481)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104008481 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:
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:
1104008481
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1680
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:
25717-1680
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:
2585 3RD AVE
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:
25703-1642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-697-1396
Provider Business Practice Location Address Fax Number:
304-697-2086
Provider Enumeration Date:
11/29/2007

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: 208D00000X , with the licence number:  22055 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 297341902 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 614938700 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000391352 . This is a "FREEDOM BLUE IND. LAB" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 010 . This is a "TRICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 614938703 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001709560 . This is a "MT. STATE BC/BS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0035071003 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 297341903 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 007 . This is a "TRICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 614938701 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 614938702 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001709562 . This is a "MT. STATE BC/BS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001773424 . This is a "MT. STATE BC/BS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 614764900 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001709561 . This is a "MT. STATE BC/BS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 297341901 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: CJ2698 . This is a "RR MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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