Basic Information
Provider Information
NPI: 1326390691
EntityType: 2
ReplacementNPI:  
OrganizationName: VALLEY HEALTH SYSTEMS, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
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Credential:  
OtherOrganizationName: VALLEY HEALTH EAST HUNTINGTON
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
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OtherLastNameType:  
Mailing Information
Address1: PO BOX 1680
Address2:  
City: HUNTINGTON
State: WV
PostalCode: 257171680
CountryCode: US
TelephoneNumber: 3046971396
FaxNumber: 3046972086
Practice Location
Address1: 3377 US ROUTE 60
Address2:  
City: HUNTINGTON
State: WV
PostalCode: 257052837
CountryCode: US
TelephoneNumber: 3043993311
FaxNumber: 3046972086
Other Information
ProviderEnumerationDate: 10/10/2012
LastUpdateDate: 10/10/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WEINBERGER
AuthorizedOfficialFirstName: RICHARD
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 3045253334
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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