Healthcare Provider Details

I. General information

NPI: 1811024417
Provider Name (Legal Business Name): VALUMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 AIRPORT RD SUITE 102
DALTON GA
30721-9201
US

IV. Provider business mailing address

2705 AIRPORT RD SUITE 102
DALTON GA
30721-9201
US

V. Phone/Fax

Practice location:
  • Phone: 706-278-4337
  • Fax: 706-278-1854
Mailing address:
  • Phone: 706-278-4337
  • Fax: 706-278-1854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRE007178
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberPHRE007178
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE007178
License Number StateGA

VIII. Authorized Official

Name: DAVID GRIFFIN
Title or Position: PARMACIST
Credential: RPH
Phone: 706-278-4337