Provider Demographics
NPI:1215203500
Name:VALLEY HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:VALLEY HEALTH SYSTEMS, INC.
Other - Org Name:VALLEY HEALTH POCA HIGH SCHOOL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-525-3334
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-525-3334
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:5B RR 2
Practice Address - Street 2:
Practice Address - City:POCA
Practice Address - State:WV
Practice Address - Zip Code:25159-9601
Practice Address - Country:US
Practice Address - Phone:304-755-5511
Practice Address - Fax:304-697-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810025304Medicaid
WV511015Medicare PIN
WV3810025304Medicaid