Provider Demographics
NPI:1265438857
Name:VALLEY ORTHOPEDIC INC
Entity type:Organization
Organization Name:VALLEY ORTHOPEDIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-493-8288
Mailing Address - Street 1:3520 E SHIELDS AVE
Mailing Address - Street 2:# 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6909
Mailing Address - Country:US
Mailing Address - Phone:559-221-1933
Mailing Address - Fax:559-221-0260
Practice Address - Street 1:3520 E SHIELDS AVE
Practice Address - Street 2:# 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6909
Practice Address - Country:US
Practice Address - Phone:559-221-1933
Practice Address - Fax:559-221-0260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HANGER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-28
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGFC000080Medicaid
0190490001Medicare NSC
CAGFC000080Medicaid