Healthcare Provider Details

I. General information

NPI: 1174647986
Provider Name (Legal Business Name): VALLEY MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 04/30/2021
Certification Date: 04/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST NORTHAMPTON HEALTH CENTER
FLORENCE MA
01062-1466
US

IV. Provider business mailing address

PO BOX 5700
BELFAST ME
04915-5700
US

V. Phone/Fax

Practice location:
  • Phone: 413-586-8400
  • Fax: 413-585-5451
Mailing address:
  • Phone: 866-431-4077
  • Fax: 413-774-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL D CARLAN V
Title or Position: PRESIDENT
Credential: MD
Phone: 413-774-6301