Provider Demographics
NPI:1285178244
Name:VALLEY CARE PHARMACY INC
Entity type:Organization
Organization Name:VALLEY CARE PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / PIC /CEO /AO
Authorized Official - Prefix:
Authorized Official - First Name:AHLET
Authorized Official - Middle Name:
Authorized Official - Last Name:HII
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:559-469-0168
Mailing Address - Street 1:323 N 11TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4511
Mailing Address - Country:US
Mailing Address - Phone:559-469-0168
Mailing Address - Fax:559-530-3401
Practice Address - Street 1:323 N 11TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4511
Practice Address - Country:US
Practice Address - Phone:559-469-0168
Practice Address - Fax:559-530-3401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-11
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY549533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166750OtherPK