Provider Demographics
NPI:1295588564
Name:NORTH VALLEY PHARMACY AND MEDICAL SUPPLIES INC
Entity type:Organization
Organization Name:NORTH VALLEY PHARMACY AND MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:NDUBISI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUEJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-365-5300
Mailing Address - Street 1:11541 LAUREL CANYON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340-4602
Mailing Address - Country:US
Mailing Address - Phone:818-365-5300
Mailing Address - Fax:
Practice Address - Street 1:11541 LAUREL CANYON BLVD STE C
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4602
Practice Address - Country:US
Practice Address - Phone:818-365-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy