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General NPI Number Information
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NPI Number | 1104813682
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Entity Type | Organization
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Legal Business Name | VALLEY-WIDE HEALTH SYSTEMS, INC
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 903 S 12TH ST
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City | ROCKY FORD
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State | CO
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Zip | 81067-2127
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Country | US
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Telephone | 719-254-7623
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Fax | 719-254-5112
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Provider Business Mailing Address
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Address Line | 128 MARKET ST
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City | ALAMOSA
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State | CO
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Zip | 81101-2290
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Country | US
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Telephone | 719-589-5161
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JANIA ARNOLDI
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Credential |
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Telephone | 719-589-5161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | CO
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