Healthcare Provider Details

I. General information

NPI: 1760543359
Provider Name (Legal Business Name): MID-VALLEY HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 MITCHELL RD STE P-U
CERES CA
95307-9227
US

IV. Provider business mailing address

200 W LEXINGTON AVE STE 203
HIGH POINT NC
27262-2599
US

V. Phone/Fax

Practice location:
  • Phone: 209-531-1858
  • Fax: 209-531-0825
Mailing address:
  • Phone: 336-309-3692
  • Fax: 855-843-3395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHY37093
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License NumberPHY37093
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPHY37093
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY37093
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY37093
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPHY37093
License Number StateCA
# 7
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License NumberPHY30793
License Number StateCA
# 8
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPHY37093
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHY37093
License Number StateCA

VIII. Authorized Official

Name: DOUGLAS E HILL
Title or Position: PRESIDENT
Credential:
Phone: 336-309-3692