Healthcare Provider Details

I. General information

NPI: 1740376730
Provider Name (Legal Business Name): VALLEY DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S MERIDIAN AVE
VALLEY CENTER KS
67147-4951
US

IV. Provider business mailing address

801 S MERIDIAN AVE
VALLEY CENTER KS
67147-4951
US

V. Phone/Fax

Practice location:
  • Phone: 316-755-0191
  • Fax: 316-755-3299
Mailing address:
  • Phone: 316-755-0191
  • Fax: 316-755-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-09919
License Number StateKS

VIII. Authorized Official

Name: MR. STEVE L PARKER
Title or Position: PIC / PRESIDENT
Credential: RPH
Phone: 316-755-0191