MEDICARE: VALLEY HEALTH SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist
2	207Q00000X	Family Medicine Physician	1926	WV
3	207Q00000X	Family Medicine Physician	1674	WV
4	207R00000X	Internal Medicine Physician	19091	WV
5	261QF0400X	Federally Qualified Health Center (FQHC)		WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CJ2698	OTHER	WV	RR MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710952056
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY HEALTH SYSTEMS INC

Provider Business Mailing Address
First Line	:	2585 3RD AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25703-1642
Country	:	US
Telephone Number	:	304-697-1396
Fax Number	:	304-697-2086

Provider Business Practice Location Address
First Line	:	1301 HAL GREER BLVD
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3803
Country	:	US
Telephone Number	:	304-525-0572
Fax Number	:	304-529-1119

Authorized Official
Title or Position	:	VICE PRESIDENT OF FINANCE / CFO
Name	:	MARY-BETH BRUBECK
Credential	:
Telephone Number	:	304-525-3334

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	03/31/2022

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Directions to “VALLEY HEALTH SYSTEMS INC ” Practice Location

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