Valley Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

200280 Issued in AK

Legal business name

VALLEY MEDICAL SUPPLY

Practice address

546 N Main St
Wasilla, AK 99654-7019

Phone

(907) 373-1014

Fax

(907) 357-1424

NPI assigned

Oct 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Glenna G. Edwards, CERTIFIED FITTER

Title

Owner / Fitter

Phone

(907) 373-1014

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1881787612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547019",
            "telephone_number": "907-373-1014",
            "fax_number": "907-357-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 N MAIN ST",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547019",
            "telephone_number": "907-373-1014",
            "fax_number": "907-357-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "GLENNA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER / FITTER",
        "authorized_official_telephone_number": "907-373-1014",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CERTIFIED FITTER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AK",
            "license": "200280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS2280",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PO2280",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Care Coordination
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• Valley Dental Clinic
• Valley Dermatology Center, Inc.
• Valley Eye Associates, PC
• Valley Orthodontics LLC
• Valley Orthopedic Surgery PC Dr Charles J Kase MD PC
• Valley Skill Center, Inc
• Valley Skill Center, Inc.
• Valley Upright Imaging LLC

• Durable Medical Equipment & Medical Supplies in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Durable Medical Equipment & Medical Supplies in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.