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General NPI Number Information
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NPI Number | 1285667626
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Entity Type | Organization
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Legal Business Name | PEACH VALLEY PHARMACY, INC.
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2306 CHESNEE HWY SUITE 1
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City | SPARTANBURG
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State | SC
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Zip | 29303-5500
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Country | US
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Telephone | 864-577-0087
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Fax | 864-577-0599
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Provider Business Mailing Address
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Address Line | 2306 CHESNEE HWY SUITE 1
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City | SPARTANBURG
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State | SC
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Zip | 29303-5500
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Country | US
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Telephone | 864-577-0087
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Fax | 864-577-0599
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. JAMES HILTON WEST II
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Credential | R.PH.
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Telephone | 864-577-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5000-5035
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License Number State | SC
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