Provider Demographics
NPI:1336771112
Name:ROANOKE VALLEY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ROANOKE VALLEY HEALTH SERVICES INC
Other - Org Name:VIDANT CANCER CARE CLINIC- ROANOKE RAPIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-535-8005
Mailing Address - Street 1:210 B SMITH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870
Mailing Address - Country:US
Mailing Address - Phone:252-535-8870
Mailing Address - Fax:252-535-8868
Practice Address - Street 1:250 SMITH CHURCH RD
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870
Practice Address - Country:US
Practice Address - Phone:252-535-8832
Practice Address - Fax:252-535-8794
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROANOKE VALLEY HEALTH SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Single Specialty