Provider Demographics
NPI:1164741617
Name:VALLEY MEDICAL FACILITIES, INC.
Entity Type:Organization
Organization Name:VALLEY MEDICAL FACILITIES, INC.
Other - Org Name:BEAVER INPATIENT REHAB UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-749-7027
Mailing Address - Street 1:1000 DUTCH RIDGE RD
Mailing Address - Street 2:INPATIENT REHAB UNIT
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-9727
Mailing Address - Country:US
Mailing Address - Phone:724-728-7000
Mailing Address - Fax:
Practice Address - Street 1:1000 DUTCH RIDGE RD
Practice Address - Street 2:INPATIENT REHAB UNIT
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-9727
Practice Address - Country:US
Practice Address - Phone:724-728-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY MEDICAL FACILITIES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-24
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA135701273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100003355Medicaid
PA390036Medicare PIN