Provider Demographics
NPI:1356455661
Name:THE VALLEY HOSPITAL INC.
Entity Type:Organization
Organization Name:THE VALLEY HOSPITAL INC.
Other - Org Name:VALLEY HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-447-8021
Mailing Address - Street 1:223 N VAN DIEN AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-2726
Mailing Address - Country:US
Mailing Address - Phone:201-447-8000
Mailing Address - Fax:
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-17
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10211O-6332B00000X
NJ28RS006109003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8793816Medicaid
NJ9109501Medicaid
NJ8837791Medicaid
NJ8793808Medicaid
NJ4471300002Medicare NSC
NJ4471300002Medicare NSC
NJ9109501Medicaid