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General NPI Number Information
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NPI Number | 1457581365
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Entity Type | Organization
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Legal Business Name | VALLEY PHARMACY
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 2960 N LITCHFIELD RD STE 120
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City | GOODYEAR
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State | AZ
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Zip | 85395-7822
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Country | US
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Telephone | 623-505-6500
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Fax | 623-505-6505
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Provider Business Mailing Address
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Address Line | 7744 PORT ARTHUR DR
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City | CORONA
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State | CA
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Zip | 92880-3537
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Country | US
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Telephone | 909-327-8467
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Fax | 623-505-6505
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AMGAD GADALLA
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Credential |
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Telephone | 623-505-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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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 | Y005172
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License Number State | AZ
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