Organization Name: | VALLEY APOTHECARY |
NPI Number: | 1285035261 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH LATHROP (PRESIDENT) |
Mailing Address: | 123 E Gardiner St Suite A Valley |
State: | NE US |
Postal Code: | 680649798 |
Phone Number: | 4023592284 |
Fax Number: | 4023592285 |
NPI Enumeration Date: | 09/10/2014 |
NPI Last Update Date: | 09/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | 2481 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |