Healthcare Provider Details

I. General information

NPI: 1679728448
Provider Name (Legal Business Name): VALLEY PRESCRIPTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 11/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 12TH ST SUITE 307
WHEELING WV
26003-3273
US

IV. Provider business mailing address

80 12TH ST SUITE 307
WHEELING WV
26003-3273
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-4004
  • Fax: 304-242-8004
Mailing address:
  • Phone: 304-242-4004
  • Fax: 304-242-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number2077
License Number StateWV

VIII. Authorized Official

Name: DR. ROLAND F CHALIFOUX, JR.
Title or Position: OWNER
Credential: D.O.
Phone: 304-242-4004