Provider Demographics
NPI:1740410380
Name:SUN VALLEY PHARMACIES INC
Entity Type:Organization
Organization Name:SUN VALLEY PHARMACIES INC
Other - Org Name:KAREN'S FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-788-4970
Mailing Address - Street 1:21 E MAPLE ST STE B
Mailing Address - Street 2:
Mailing Address - City:HAILEY
Mailing Address - State:ID
Mailing Address - Zip Code:83333-4900
Mailing Address - Country:US
Mailing Address - Phone:208-788-4970
Mailing Address - Fax:208-788-5791
Practice Address - Street 1:21 E MAPLE ST STE B
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333-4900
Practice Address - Country:US
Practice Address - Phone:208-788-4970
Practice Address - Fax:208-788-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID6407540001Medicare NSC