Provider Demographics
NPI:1396851382
Name:VALLEY GERIATRICS INC
Entity Type:Organization
Organization Name:VALLEY GERIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BENJAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:540-448-2190
Mailing Address - Street 1:213 SKYLAND DR
Mailing Address - Street 2:
Mailing Address - City:STAUNTON
Mailing Address - State:VA
Mailing Address - Zip Code:24401-2358
Mailing Address - Country:US
Mailing Address - Phone:540-448-2190
Mailing Address - Fax:
Practice Address - Street 1:1225 RESERVOIR ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4415
Practice Address - Country:US
Practice Address - Phone:540-433-2623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADF0853OtherRAILROAD MEDICARE
VADF0853OtherRAILROAD MEDICARE