Provider Demographics
NPI:1316933088
Name:CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
Entity type:Organization
Organization Name:CHATTAHOOCHEE VALLEY HOSPITAL SOCIETY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-756-1950
Mailing Address - Street 1:1806 44TH ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36854-3441
Mailing Address - Country:US
Mailing Address - Phone:334-756-1950
Mailing Address - Fax:334-756-1970
Practice Address - Street 1:1806 44TH ST
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:AL
Practice Address - Zip Code:36854-3441
Practice Address - Country:US
Practice Address - Phone:334-756-1950
Practice Address - Fax:334-756-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51043280OtherBLUE CROSS BLUE SHIELD
ALLAN7123AMedicaid
AL017123Medicare ID - Type Unspecified