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General NPI Number Information
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NPI Number | 1639549645
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Entity Type | Organization
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Legal Business Name | INLAND VALLEY PHARMACY INC
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 03/17/2022
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Provider Practice Location Address
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Address Line | 3349 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92545-3513
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Country | US
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Telephone | 951-766-5100
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Fax | 951-766-5114
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Provider Business Mailing Address
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Address Line | 3349 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92545-3513
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Country | US
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Telephone | 951-766-5100
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Fax | 951-766-5114
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. AMIE PERALTA
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Credential |
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Telephone | 951-766-5100
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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 | PHY 53641
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License Number State | CA
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