Provider Demographics
NPI:1912196791
Name:VALLEY REGIONAL ENTERPRISES, INC.
Entity Type:Organization
Organization Name:VALLEY REGIONAL ENTERPRISES, INC.
Other - Org Name:VALLEY MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, VRE
Authorized Official - Prefix:MR
Authorized Official - First Name:M
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:HEISEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-5260
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-8060
Mailing Address - Country:US
Mailing Address - Phone:540-536-4331
Mailing Address - Fax:540-536-2396
Practice Address - Street 1:295 FRONT ROYAL PIKE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-7325
Practice Address - Country:US
Practice Address - Phone:540-536-5422
Practice Address - Fax:540-536-2396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVNA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD590011827OtherMEDICARE RAILROAD
WVAM8453410101OtherBS MARYLAND
WV1385406OtherUMWA
WV590004610OtherMEDICARE RAILROAD
MD590011827OtherMEDICARE RAILROAD
WV=========001OtherWV COMP
WVAM8453410101OtherBS MARYLAND
WV590004610OtherMEDICARE RAILROAD
VA590000074Medicare PIN