Provider Demographics
NPI:1427406248
Name:MID-VALLEY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MID-VALLEY HEALTHCARE, INC.
Other - Org Name:SAMCARE MOBILE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-769-5009
Mailing Address - Street 1:33184 HIGHWAY 228
Mailing Address - Street 2:
Mailing Address - City:HALSEY
Mailing Address - State:OR
Mailing Address - Zip Code:97348-9717
Mailing Address - Country:US
Mailing Address - Phone:541-451-7873
Mailing Address - Fax:
Practice Address - Street 1:33184 HIGHWAY 228
Practice Address - Street 2:
Practice Address - City:HALSEY
Practice Address - State:OR
Practice Address - Zip Code:97348-9717
Practice Address - Country:US
Practice Address - Phone:541-451-7873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty