# HERITAGE VALLEY MEDICAL GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HERITAGE VALLEYMEDICAL GROUP, INC.
- **Other names:** HVMG Foot and Ankle
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1407415987
- **Legal business name:** HERITAGE VALLEYMEDICAL GROUP, INC.
- **Authorized official:** BRYAN J RANDALL (VICE PRESIDENT & CFO)
- **Authorized official phone:** (412) 749-7027

## Contact information

- **Practice address:** 79 WAGNER ROAD, SUITE 103, MONACA, PA 15061-2338
- **Practice address phone:** (878) 439-3598
- **Practice address fax:** (878) 439-3599
- **Mailing address:** 1000 DUTCH RIDGE RD, BEAVER, PA 15009-9727
- **Mailing address phone:** (724) 773-4776
- **Mailing address fax:** (724) 773-4726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/10/2019
- **Last updated:** 06/10/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00156544 | — | PA |