Healthcare Provider Details

I. General information

NPI: 1720310022
Provider Name (Legal Business Name): VALLEY HEALTH SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PIONEER RD
WAYNE WV
25570-9504
US

IV. Provider business mailing address

PO BOX 1680
HUNTINGTON WV
25717-1680
US

V. Phone/Fax

Practice location:
  • Phone: 304-272-3783
  • Fax:
Mailing address:
  • Phone: 304-697-1396
  • Fax: 304-697-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3807
License Number StateWV

VIII. Authorized Official

Name: RICHARD WEINBERGER
Title or Position: CFO
Credential:
Phone: 304-525-3334