Provider Demographics
NPI:1720456874
Name:VALLEY PRIMARY CARE LLC
Entity Type:Organization
Organization Name:VALLEY PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-275-4941
Mailing Address - Street 1:2745 S ALMA SCHOOL RD
Mailing Address - Street 2:2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4405
Mailing Address - Country:US
Mailing Address - Phone:480-855-7585
Mailing Address - Fax:480-855-0912
Practice Address - Street 1:2745 S ALMA SCHOOL RD
Practice Address - Street 2:2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-4405
Practice Address - Country:US
Practice Address - Phone:480-855-7585
Practice Address - Fax:480-855-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-07
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care