Provider Demographics
NPI:1306667332
Name:VALLEY PHARMACY LLC
Entity type:Organization
Organization Name:VALLEY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAR
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:CHANDALURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-200-0945
Mailing Address - Street 1:5055 SUN VALLEY BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-8299
Mailing Address - Country:US
Mailing Address - Phone:775-200-0945
Mailing Address - Fax:775-288-5199
Practice Address - Street 1:5055 SUN VALLEY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89433-8299
Practice Address - Country:US
Practice Address - Phone:775-200-0945
Practice Address - Fax:775-288-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy