Provider Demographics
NPI:1407961766
Name:VALHALLA ENTERPRISES INC
Entity Type:Organization
Organization Name:VALHALLA ENTERPRISES INC
Other - Org Name:FIGLIOMENI HOME HEALTH CARE SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:R
Authorized Official - Last Name:MANCUSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-282-1402
Mailing Address - Street 1:24 N CHURCH ST
Mailing Address - Street 2:STE 1
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-1973
Mailing Address - Country:US
Mailing Address - Phone:570-282-1402
Mailing Address - Fax:570-282-3377
Practice Address - Street 1:24 N CHURCH ST
Practice Address - Street 2:STE 1
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-1973
Practice Address - Country:US
Practice Address - Phone:570-282-1402
Practice Address - Fax:570-282-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000003725332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPA-31651 PA-14185OtherPA BEDDING & UPHOLSTERY REGISTRATION/PERMIT
PA102544040 0001Medicaid
PA6000003725OtherPA DEPT OF HEALTH DRUG & DEVICE REGISTRATION
PA0012746720001Medicaid
PA5397860001Medicare NSC