Healthcare Provider Details

I. General information

NPI: 1144096082
Provider Name (Legal Business Name): VALLEY HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 TEAYS VALLEY RD
HURRICANE WV
25526-9705
US

IV. Provider business mailing address

PO BOX 1680
HUNTINGTON WV
25717-1680
US

V. Phone/Fax

Practice location:
  • Phone: 304-982-7031
  • Fax:
Mailing address:
  • Phone: 304-781-5159
  • Fax: 304-523-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MARY-BETH N. BRUBECK
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 304-525-3334