Provider Demographics
NPI:1477216919
Name:VALLEY HEALTH SYSTEMS INC
Entity Type:Organization
Organization Name:VALLEY HEALTH SYSTEMS INC
Other - Org Name:VALLEY HEALTH-WOODRUFF & GONZALES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE / CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY-BETH
Authorized Official - Middle Name:N
Authorized Official - Last Name:BRUBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-525-3334
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-781-5159
Mailing Address - Fax:304-523-8115
Practice Address - Street 1:1319 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3803
Practice Address - Country:US
Practice Address - Phone:304-529-6060
Practice Address - Fax:304-529-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No122300000XDental ProvidersDentistGroup - Single Specialty