Provider Demographics
NPI:1154774032
Name:ROANOKE VALLEY HEALTH SERVICES, INC
Entity type:Organization
Organization Name:ROANOKE VALLEY HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-535-8005
Mailing Address - Street 1:240 SMITH CHURCH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-4903
Mailing Address - Country:US
Mailing Address - Phone:252-535-1082
Mailing Address - Fax:
Practice Address - Street 1:210 SMITH CHURCH RD STE B
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-4942
Practice Address - Country:US
Practice Address - Phone:252-535-1082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty