Provider Demographics
NPI:1457898892
Name:VALLEY PHARMACIES, INC.
Entity Type:Organization
Organization Name:VALLEY PHARMACIES, INC.
Other - Org Name:WELLNESS CONCEPTS OF ROANOKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:540-689-0935
Mailing Address - Street 1:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:GROTTOES
Mailing Address - State:VA
Mailing Address - Zip Code:24441-0338
Mailing Address - Country:US
Mailing Address - Phone:540-689-0935
Mailing Address - Fax:540-249-0441
Practice Address - Street 1:6701 PETERS CREEK RD STE 109
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-4060
Practice Address - Country:US
Practice Address - Phone:540-689-0935
Practice Address - Fax:540-249-0441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010047553336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy