Provider Demographics
NPI:1437291853
Name:VALLEY MEDICAL FACILITIES, INC.
Entity Type:Organization
Organization Name:VALLEY MEDICAL FACILITIES, INC.
Other - Org Name:SEWICKLEY VALLEY HOSPITAL, STAUNTON CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:412-749-7010
Mailing Address - Street 1:618 RUSSELLWOOD AVE
Mailing Address - Street 2:STAUNTON CLINIC- MCKEES ROCKS
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-3020
Mailing Address - Country:US
Mailing Address - Phone:412-771-7610
Mailing Address - Fax:
Practice Address - Street 1:618 RUSSELLWOOD AVE
Practice Address - Street 2:STAUNTON CLINIC- MCKEES ROCKS
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-3020
Practice Address - Country:US
Practice Address - Phone:412-771-7610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA940070261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000033550172Medicaid
PA0924OtherHIGHMARK BLUE CROSS
PA1000033550172Medicaid