Provider Demographics
NPI:1205904752
Name:VALLEY PULMONARY & CRITICAL CARE, P.C.
Entity type:Organization
Organization Name:VALLEY PULMONARY & CRITICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-353-4665
Mailing Address - Street 1:1101 SOMERVILLE RD SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3242
Mailing Address - Country:US
Mailing Address - Phone:256-353-4665
Mailing Address - Fax:256-353-8982
Practice Address - Street 1:1101 SOMERVILLE RD SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3242
Practice Address - Country:US
Practice Address - Phone:256-353-4665
Practice Address - Fax:256-353-8982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22105207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529804170Medicaid
AL510-79820OtherBLUE CROSS& BLUE SHIELD
AL102G702006OtherMEDICARE GROUP PTAN
AL102G702006OtherMEDICARE GROUP PTAN