Healthcare Provider Details

I. General information

NPI: 1033536883
Provider Name (Legal Business Name): VALLEY INFUSION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 W MAIN ST
WAYNESBORO VA
22980-4312
US

IV. Provider business mailing address

1115 W MAIN ST
WAYNESBORO VA
22980-4312
US

V. Phone/Fax

Practice location:
  • Phone: 540-569-3463
  • Fax: 888-801-3124
Mailing address:
  • Phone: 540-569-3463
  • Fax: 888-801-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201004601
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PRESTON ESTEP
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 540-569-3463