Provider Demographics
NPI:1336470293
Name:VALLEY CENTER FOR NERVE STUDIES AND REHABILITATION
Entity Type:Organization
Organization Name:VALLEY CENTER FOR NERVE STUDIES AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:R
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-382-1603
Mailing Address - Street 1:PO BOX 18364
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-8364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 MAGNOLIA AVE SOUTH
Practice Address - Street 2:SUITE 411
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35298
Practice Address - Country:US
Practice Address - Phone:256-382-1603
Practice Address - Fax:256-382-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18624208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000023502OtherMEDICARE PCAN
AL000023502Medicaid
AL1740238112OtherNPI FOR ERIC R BECK, MD
ALF55413OtherBLUE CROSS OF ALABAMA UPIN