1801003934 NPI number — VALLEY VIEW REGIONAL HOSPITAL

Table of content: (NPI 1801003934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801003934 NPI number — VALLEY VIEW REGIONAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY VIEW REGIONAL HOSPITAL
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:
1801003934
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 850
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRATFORD
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74872-0850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-759-2336
Provider Business Mailing Address Fax Number:
580-332-0383

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 WEST SMITH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STRATFORD
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74872-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-759-2336
Provider Business Practice Location Address Fax Number:
580-332-0383
Provider Enumeration Date:
05/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KRAUSE
Authorized Official First Name:
MARY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
580-421-1412

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100728840H , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".