Provider Demographics
NPI:1063506707
Name:VALLEY SURGERY CENTER, L.L.C.
Entity type:Organization
Organization Name:VALLEY SURGERY CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:G.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:256-768-1711
Mailing Address - Street 1:4819 HUNTSVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-768-1711
Mailing Address - Fax:256-764-7090
Practice Address - Street 1:4819 HUNTSVILLE ROAD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-768-1711
Practice Address - Fax:256-764-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12132261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550837Medicaid
ALASC0056CMedicaid
AL490004461Medicare ID - Type UnspecifiedMEDICARE RAILROAD
AL051550837Medicare ID - Type UnspecifiedANESTHESIA
AL000058827Medicare ID - Type UnspecifiedFACILITY
AL051550837Medicaid