Organization
VALLEY HEALTHCARE SYSTEM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH E LANG (CHEIF EXECUTIVE OFFICER)
(706) 322-9599
Entity
Organization
Contact information
Practice address
94 MCCRARY ROAD, FORTSON, GA 31808
(706) 987-8216
(706) 987-8220
Mailing address
1600 FORT BENNING RD, COLUMBUS, GA 31903-2834
(706) 322-9599
(706) 322-9567
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000617196K
—
GA
01
—
202G702049
MEDICARE PTAN
GA
Enumeration date
10/09/2007
Last updated
07/02/2018
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