Provider Demographics
NPI:1013014299
Name:VALABCO INC
Entity Type:Organization
Organization Name:VALABCO INC
Other - Org Name:ORDWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDINALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-372-8085
Mailing Address - Street 1:499 ALVARADO ST
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2739
Mailing Address - Country:US
Mailing Address - Phone:831-372-8085
Mailing Address - Fax:831-372-6426
Practice Address - Street 1:499 ALVARADO ST
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2739
Practice Address - Country:US
Practice Address - Phone:831-372-8085
Practice Address - Fax:831-372-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY373133336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2066035OtherPK
CAPHA373130Medicaid
2066035OtherPK