| Organization Name: | COMMUNITY PHARMACY OF VALE LLC |
| NPI Number: | 1912170507 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH A LONG (MANAGER) |
| Mailing Address: | 9576 Nc Hwy 10w Vale |
| State: | NC US |
| Postal Code: | 281687451 |
| Phone Number: | 7044620226 |
| Fax Number: | 7044620229 |
| NPI Enumeration Date: | 04/04/2008 |
| NPI Last Update Date: | 08/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |