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	10966	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	614764900	OTHER	WV	BLACK LUNG

General Provider Information

NPI Number	:	1891775557
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	:	308 E MAIN ST
Second Line	:
City	:	MILTON
State	:	WV
Zip	:	25541-1508
Country	:	US
Telephone Number	:	304-743-4444
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	RICHARD WEINBERGER
Credential	:
Telephone Number	:	304-525-3334

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	12/07/2011

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Directions to “VALLEY HEALTH SYSTEMS INC ” Practice Location

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