Healthcare Provider Details

I. General information

NPI: 1811477342
Provider Name (Legal Business Name): THE VALLEY HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MACARTHUR BLVD
MAHWAH NJ
07430-3618
US

IV. Provider business mailing address

223 N VAN DIEN AVE
RIDGEWOOD NJ
07450-2726
US

V. Phone/Fax

Practice location:
  • Phone: 201-316-8444
  • Fax:
Mailing address:
  • Phone: 201-447-8434
  • Fax: 201-389-0818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND HAWASH
Title or Position: PHARMACIST IN CHARGE
Credential: PHARMD
Phone: 201-447-8434