Organization
VALLEY HEALTH SYSTEMS INC
Active
Other names
Valley Health Fort Gay
Organization subpart
No
Provider details
NPI number
Authorized official
MARY-BETH BRUBECK (VICE PRESIDENT OF FINANCE / CFO)
(304) 525-3334
Entity
Organization
Contact information
Practice address
71 WAYNE ST, FORT GAY, WV 25514
(304) 648-5544
(304) 648-5989
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
WV
122300000X
Dentist
2768
WV
207Q00000X
Family Medicine Physician
1744
WV
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WV
363A00000X
Physician Assistant
—
WV
363LF0000X
Family Nurse Practitioner
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035071000
—
WV
05
—
2752543
—
OH
01
—
614938702
BLACK LUNG
WV
05
—
61900841
—
KY
05
—
65916702
—
KY
05
—
6593981100
—
KY
01
—
CJ2698
RR MEDICARE GROUP
WV
Enumeration date
01/19/2006
Last updated
03/31/2022
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