Provider Demographics
NPI:1124323340
Name:VALLEY HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:VALLEY HEALTH SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE / CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARY-BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-525-3334
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-697-1396
Mailing Address - Fax:304-697-2086
Practice Address - Street 1:2801 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:WV
Practice Address - Zip Code:25550
Practice Address - Country:US
Practice Address - Phone:304-675-4107
Practice Address - Fax:304-697-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0072865Medicaid
OH0097852Medicaid
WV3810021158Medicaid
WV3810021158Medicaid
511967Medicare Oscar/Certification