Healthcare Provider Details

I. General information

NPI: 1437333424
Provider Name (Legal Business Name): VALLEY HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BRIDGE BLVD SW
ALBUQUERQUE NM
87105-3765
US

IV. Provider business mailing address

1010 BRIDGE BLVD SW
ALBUQUERQUE NM
87105-3765
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-4258
  • Fax: 505-873-4260
Mailing address:
  • Phone: 505-873-4258
  • Fax: 505-873-4260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNM

VIII. Authorized Official

Name: MR. JAMES A ROEDEMA
Title or Position: CEO
Credential:
Phone: 720-434-0245