Healthcare Provider Details

I. General information

NPI: 1295540466
Provider Name (Legal Business Name): VALLE DEL SOL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4344 W INDIAN SCHOOL RD STE 16
PHOENIX AZ
85031-2985
US

IV. Provider business mailing address

3877 N 7TH ST STE 400
PHOENIX AZ
85014-5061
US

V. Phone/Fax

Practice location:
  • Phone: 602-258-6797
  • Fax:
Mailing address:
  • Phone: 602-258-6797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MIKE RENAUD
Title or Position: PRESIDENT & CEO
Credential:
Phone: 602-258-6797