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General NPI Number Information
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NPI Number | 1508934308
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Entity Type | Organization
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Legal Business Name | VALLEY VIEW PHARMACY INC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 4910 VALLEY VIEW BLVD NW
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City | ROANOKE
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State | VA
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Zip | 24012-2040
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Country | US
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Telephone | 540-366-2112
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Fax | 540-366-7201
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Provider Business Mailing Address
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Address Line | 4910 VALLEY VIEW BLVD NW
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City | ROANOKE
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State | VA
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Zip | 24012-2040
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Country | US
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Telephone | 540-366-2112
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Fax | 540-366-7201
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOMMIE NICHOLS
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Credential | RPH
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Telephone | 540-366-2112
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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 |
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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 | 0201002495
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License Number State | VA
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