MEDICARE: VALLEY FALLS PHARMACY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy	2-103438	KS
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336L0003X	Long Term Care Pharmacy	2-103438	KS
4	3336S0011X	Specialty Pharmacy	2-103438	KS
5	3336C0003X	Community/Retail Pharmacy	2-103438	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2-103438	OTHER	KS	STATE PHARMACY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104349554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY FALLS PHARMACY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 267
Second Line	:
City	:	HERINGTON
State	:	KS
Zip	:	67449-0267
Country	:	US
Telephone Number	:	785-945-3711
Fax Number	:	785-945-6156

Provider Business Practice Location Address
First Line	:	320 BROADWAY ST
Second Line	:
City	:	VALLEY FALLS
State	:	KS
Zip	:	66088-1302
Country	:	US
Telephone Number	:	785-945-3711
Fax Number	:	785-945-6156

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID RZIHA
Credential	:	PHARMD
Telephone Number	:	785-945-3711

Provider Enumeration Date	:	07/18/2017
Last Update Date	:	02/17/2021

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