MEDICARE: VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER

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	208000000X	Pediatrics Physician
2	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1578398319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	PO BOX 4311
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18105-4311
Country	:	US
Telephone Number	:	484-884-4500
Fax Number	:	484-884-0699

Provider Business Practice Location Address
First Line	:	205 APPLEGATE RD STE 200
Second Line	:
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-6502
Country	:	US
Telephone Number	:	570-476-3585
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	PHILIP DOMAN
Credential	:
Telephone Number	:	610-764-8326

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	05/11/2026

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