Provider Demographics
NPI:1326304577
Name:MIDV-VALLEY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MIDV-VALLEY HEALTHCARE, INC.
Other - Org Name:MID-VALLEY PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-451-7107
Mailing Address - Street 1:701 N 5TH ST
Mailing Address - Street 2:SUITE C-1020
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-9559
Mailing Address - Country:US
Mailing Address - Phone:541-451-7820
Mailing Address - Fax:
Practice Address - Street 1:701 N 5TH ST
Practice Address - Street 2:SUITE C-1020
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-9559
Practice Address - Country:US
Practice Address - Phone:541-451-7820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty