Healthcare Provider Details

I. General information

NPI: 1235178591
Provider Name (Legal Business Name): VALLEY REGIONAL ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 E JUBAL EARLY DR
WINCHESTER VA
22601-5178
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 320
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-2221
  • Fax: 540-536-7681
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number0101057756
License Number StateVA

VIII. Authorized Official

Name: JILL CHAMBERS
Title or Position: MANAGER INSURANCE CREDENTIALING
Credential:
Phone: 540-536-0231