Basic Information
| Provider Information | |||||||||
| NPI: | 1952444523 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALLEY-WIDE HEALTH SYSTEMS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 128 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | ALAMOSA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 811012290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195895161 | ||||||||
| FaxNumber: | 7195895722 | ||||||||
| Practice Location | |||||||||
| Address1: | 128 MARKET ST | ||||||||
| Address2: | |||||||||
| City: | ALAMOSA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 811012290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7195895161 | ||||||||
| FaxNumber: | 7195895722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 02/03/2020 | ||||||||
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| AuthorizedOfficialLastName: | ARNOLDI | ||||||||
| AuthorizedOfficialFirstName: | JANIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 7195895161 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 343900000X | Y | Transportation Services | Non-emergency Medical Transport (VAN) |
ID Information
| ID | Type | State | Issuer | Description | 17378273 | 05 | CO | MEDICAID |