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NPI Code Detail

MEDICARE: VALLEY PHARMACY, INC DBA FARMINGTON MEDICAL SUPPLIES AND SERVICES

MEDICARE: VALLEY PHARMACY, INC DBA FARMINGTON MEDICAL SUPPLIES AND SERVICES
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
1332B00000XDurable Medical Equipment & Medical Supplies0230189ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1003238OTHERMEANTHEM

General Provider Information

NPI Number : 1326044645
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY PHARMACY, INC DBA FARMINGTON MEDICAL SUPPLIES AND SERVICES
Provider Business Mailing Address
First Line : 407 WILTON RD
Second Line : SUITE 3
City : FARMINGTON
State : ME
Zip : 04938-6125
Country : US
Telephone Number : 207-778-2520
Fax Number : 207-778-0313
Provider Business Practice Location Address
First Line : 407 WILTON RD
Second Line : SUITE 3
City : FARMINGTON
State : ME
Zip : 04938-6125
Country : US
Telephone Number : 207-778-2520
Fax Number : 207-778-0313
Authorized Official
Title or Position : CEO
Name : MISS BRENDA MARIE LAVIOLETTE
Credential :
Telephone Number : 207-778-2520
Provider Enumeration Date : 06/22/2005
Last Update Date : 11/01/2007

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