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General NPI Number Information
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NPI Number | 1518049394
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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 | 10/20/2006
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 24465 SUNNYMEAD BLVD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-9313
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Country | US
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Telephone | 951-924-7720
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Fax | 951-924-1044
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Provider Business Mailing Address
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Address Line | 24465 SUNNYMEAD BLVD
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City | MORENO VALLEY
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State | CA
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Zip | 92553-9313
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Country | US
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Telephone | 951-924-7720
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Fax | 951-924-1044
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Authorized Official
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Title or Position | PHARMACY MANAGER/ OWNER
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Name | MR. NADER ABADIER
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Credential |
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Telephone | 951-924-7720
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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 | PHY49854
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License Number State | CA
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