Provider Demographics
NPI:1346314515
Name:VALLEY RADIOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:VALLEY RADIOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCLARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-927-9209
Mailing Address - Street 1:1900 W PARK DR
Mailing Address - Street 2:PO BOX 456
Mailing Address - City:N WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3563
Mailing Address - Country:US
Mailing Address - Phone:336-927-9209
Mailing Address - Fax:
Practice Address - Street 1:1370 W D ST
Practice Address - Street 2:
Practice Address - City:N WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3506
Practice Address - Country:US
Practice Address - Phone:336-927-9209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89O16E9Medicaid
NCDA2465OtherRAILROAD MEDICARE GRP #
NCO16E9OtherNC BCBS GROUP PROV #
NCO16E9OtherNC BCBS GROUP PROV #
NC89O16E9Medicaid