Provider Demographics
NPI:1376563783
Name:VALLEY VIEW HOSPITAL
Entity Type:Organization
Organization Name:VALLEY VIEW HOSPITAL
Other - Org Name:D/B/A VALLEY VIEW REGIONAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-332-2323
Mailing Address - Street 1:430 N MONTE VISTA ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4610
Mailing Address - Country:US
Mailing Address - Phone:580-332-1892
Mailing Address - Fax:580-421-1394
Practice Address - Street 1:401 N MONTE VISTA ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4609
Practice Address - Country:US
Practice Address - Phone:580-421-1477
Practice Address - Fax:580-421-1394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VALLEY VIEW REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2286251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377011Medicare Oscar/Certification
37-7011Medicare PIN