Provider Demographics
NPI:1922374511
Name:MID-VALLEY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MID-VALLEY HEALTHCARE, INC.
Other - Org Name:LEBANON SURGICAL ASSOCIATES
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:541-768-7009
Mailing Address - Street 1:100 MULLINS DR
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3982
Mailing Address - Country:US
Mailing Address - Phone:541-451-6412
Mailing Address - Fax:
Practice Address - Street 1:100 MULLINS DR
Practice Address - Street 2:SUITE C-1
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3982
Practice Address - Country:US
Practice Address - Phone:541-451-6412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty