Provider Demographics
NPI:1770570004
Name:SHENANDOAH VALLEY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:SHENANDOAH VALLEY HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:M
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:HEISEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-536-5260
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22604-8060
Mailing Address - Country:US
Mailing Address - Phone:540-536-5229
Mailing Address - Fax:540-536-4359
Practice Address - Street 1:762 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1108
Practice Address - Country:US
Practice Address - Phone:540-459-2000
Practice Address - Fax:540-459-8540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
060972OtherBS TRIGON
1068260OtherWV COMP
00239198OtherBS MT STATE
21638OtherCOMMNUITY HEALTH CHN
2122109OtherMAMSI
164072OtherSOUTHERN HEALTH
1068260OtherWV COMP
=========OtherCHAMPUS
21638OtherCOMMNUITY HEALTH CHN
1068260OtherWV COMP