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General NPI Number Information
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NPI Number | 1003244526
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Entity Type | Organization
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Legal Business Name | WEST VALLEY PHARMACY LLC
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Dates
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Enumeration Date | 10/18/2013
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 12851 W BELL RD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85378-9600
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Country | US
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Telephone | 623-533-6514
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Fax | 623-518-2860
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Provider Business Mailing Address
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Address Line | 12851 W BELL RD STE 110
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City | SURPRISE
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State | AZ
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Zip | 85378-9600
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Country | US
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Telephone | 623-533-6514
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Fax | 623-518-2860
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Authorized Official
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Title or Position | CFO
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Name | VERA ABRAMOVA
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Credential |
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Telephone | 516-422-8477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH03717
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | Y007035
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License Number State | AZ
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