Healthcare Provider Details

I. General information

NPI: 1346329828
Provider Name (Legal Business Name): VALLEY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 COTTAGE AVE
CASHMERE WA
98815
US

IV. Provider business mailing address

119 COTTAGE AVE
CASHMERE WA
98815
US

V. Phone/Fax

Practice location:
  • Phone: 509-782-2717
  • Fax: 509-782-3262
Mailing address:
  • Phone: 509-782-2717
  • Fax: 509-782-3262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberCF00000895
License Number StateWA

VIII. Authorized Official

Name: JEFFREY SHANE HARRELL
Title or Position: OWNER
Credential:
Phone: 509-782-2717