Provider Demographics
NPI:1710998208
Name:DND PHARMACY INC
Entity Type:Organization
Organization Name:DND PHARMACY INC
Other - Org Name:VALLEY MEDICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DHAVAL (DAN)
Authorized Official - Middle Name:
Authorized Official - Last Name:VITHALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-344-6303
Mailing Address - Street 1:630 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRAWLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92227-2548
Mailing Address - Country:US
Mailing Address - Phone:760-344-6303
Mailing Address - Fax:760-344-6321
Practice Address - Street 1:630 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRAWLEY
Practice Address - State:CA
Practice Address - Zip Code:92227-2548
Practice Address - Country:US
Practice Address - Phone:760-344-6303
Practice Address - Fax:760-344-6321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY339573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA339570Medicaid
0585957OtherNCPDP PROVIDER IDENTIFICATION NUMBER