Provider Demographics
NPI:1467616508
Name:MIDVALLEY RX PHARMACY
Entity Type:Organization
Organization Name:MIDVALLEY RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILA
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-527-4013
Mailing Address - Street 1:2519 ROYAL AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4700
Mailing Address - Country:US
Mailing Address - Phone:805-527-4013
Mailing Address - Fax:805-527-3756
Practice Address - Street 1:2519 ROYAL AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4700
Practice Address - Country:US
Practice Address - Phone:805-527-4013
Practice Address - Fax:805-527-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY307763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy