Healthcare Provider Details

I. General information

NPI: 1508398934
Provider Name (Legal Business Name): J.J. VALLEY DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96 ROUTE 59
SPRING VALLEY NY
10977-5217
US

IV. Provider business mailing address

96 ROUTE 59
SPRING VALLEY NY
10977-5217
US

V. Phone/Fax

Practice location:
  • Phone: 845-459-6611
  • Fax: 845-459-6613
Mailing address:
  • Phone: 845-459-6611
  • Fax: 845-459-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JOSE MIGUEL PICHARDO
Title or Position: VICE PRESIDENT
Credential:
Phone: 845-459-6611