Healthcare Provider Details

I. General information

NPI: 1851381958
Provider Name (Legal Business Name): VALLEY PHARMACY & DME OF EAST ALABAMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 20TH AVE
VALLEY AL
36854-3448
US

IV. Provider business mailing address

4103 20TH AVE
VALLEY AL
36854-3448
US

V. Phone/Fax

Practice location:
  • Phone: 334-756-2037
  • Fax: 334-756-9024
Mailing address:
  • Phone: 334-756-2037
  • Fax: 334-756-9024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANGELA MOORE
Title or Position: PRESIDENT
Credential: RPH
Phone: 334-756-2037