Provider Demographics
NPI:1396812491
Name:VALLEY ENDOSCOPY CENTER, INC
Entity type:Organization
Organization Name:VALLEY ENDOSCOPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NITESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNAKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-699-2747
Mailing Address - Street 1:PO BOX 6230
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-0722
Mailing Address - Country:US
Mailing Address - Phone:304-242-7106
Mailing Address - Fax:304-242-7108
Practice Address - Street 1:68377 STEWART DR STE 202
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1718
Practice Address - Country:US
Practice Address - Phone:740-699-2747
Practice Address - Fax:740-699-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0702AS261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6905019000Medicaid
OH2428715Medicaid
WV6905019000Medicaid