Provider Demographics
NPI:1194011296
Name:VALLEY MEDICAL FACILITIES, INC.
Entity Type:Organization
Organization Name:VALLEY MEDICAL FACILITIES, INC.
Other - Org Name:STAUNTON CLINIC, BEAVER FALLS
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 1:1125 7TH AVENUE
Mailing Address - Street 2:FAMILY MEDICINE CLINIC
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4426
Mailing Address - Country:US
Mailing Address - Phone:724-773-8970
Mailing Address - Fax:
Practice Address - Street 1:1125 7TH AVENUE
Practice Address - Street 2:FAMILY PRACTICE CENTER
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4426
Practice Address - Country:US
Practice Address - Phone:724-773-8970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY MEDICAL FACILITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA135701261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0915OtherHIGHMARK
PA100003355Medicaid
PA100003355Medicaid