MEDICARE: VALLEY HEALTH SYSTEMS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	207Y00000X	Otolaryngology Physician
3	208000000X	Pediatrics Physician
4	261QF0400X	Federally Qualified Health Center (FQHC)		WV
5	363A00000X	Physician Assistant
6	363LF0000X	Family Nurse Practitioner
7	207RI0011X	Interventional Cardiology Physician
8	207V00000X	Obstetrics & Gynecology Physician	1195	WV
9	207V00000X	Obstetrics & Gynecology Physician	20669	WV
10	207V00000X	Obstetrics & Gynecology Physician	20870	WV
11	207V00000X	Obstetrics & Gynecology Physician	1329	WV
12	207V00000X	Obstetrics & Gynecology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	CJ2698	OTHER	WV	RR MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	001767874	OTHER	WV	MT. STATE BC/BS
5	297341903	OTHER	WV	BLACK LUNG

General Provider Information

NPI Number	:	1184699415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY HEALTH SYSTEMS INC

Provider Business Mailing Address
First Line	:	PO BOX 1680
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25717-1680
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2585 3RD AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25703
Country	:	US
Telephone Number	:	304-525-3334
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF FINANCE / CFO
Name	:	MARY-BETH BRUBECK
Credential	:
Telephone Number	:	304-525-3334

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	04/01/2025

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Directions to “VALLEY HEALTH SYSTEMS INC ” Practice Location

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