Provider Demographics
NPI:1235178591
Name:VALLEY REGIONAL ENTERPRISES, INC
Entity Type:Organization
Organization Name:VALLEY REGIONAL ENTERPRISES, INC
Other - Org Name:VALLEY HEALTH URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER INSURANCE CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-0231
Mailing Address - Street 1:PO BOX 37145
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3145
Mailing Address - Country:US
Mailing Address - Phone:540-536-2221
Mailing Address - Fax:540-536-7681
Practice Address - Street 1:607 E JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5178
Practice Address - Country:US
Practice Address - Phone:540-536-2221
Practice Address - Fax:540-536-7681
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY REGIONAL ENTERPRISES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-05
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057756261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA085740OtherANTHEM
VA2122697OtherMAMSI,MAPSI,MDIPA
VA2122697OtherALLIANCE, OPTIMUM CHOICE
VA2122697OtherALLIANCE, OPTIMUM CHOICE
VA085740OtherANTHEM
VAC03625Medicare PIN