Provider Demographics
NPI:1871770693
Name:VALLEY REGIONAL MEDICAL SERVICES
Entity type:Organization
Organization Name:VALLEY REGIONAL MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP, CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDRURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-687-0156
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2859
Mailing Address - Country:US
Mailing Address - Phone:603-893-4687
Mailing Address - Fax:603-893-3676
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2859
Practice Address - Country:US
Practice Address - Phone:603-893-4687
Practice Address - Fax:603-893-3676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30210508Medicaid
NHVALL165764OtherNH BLUE CROSS BLUE SHIELD
NHRE3707Medicare PIN