Provider Demographics
NPI:1750965786
Name:VALLEY PHARMACY LLC
Entity type:Organization
Organization Name:VALLEY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:CANALES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:956-487-2711
Mailing Address - Street 1:2510 WISTERIA ST
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-6903
Mailing Address - Country:US
Mailing Address - Phone:956-487-2711
Mailing Address - Fax:956-487-6399
Practice Address - Street 1:129 N FM 3167 STE B
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-6211
Practice Address - Country:US
Practice Address - Phone:956-487-2711
Practice Address - Fax:956-487-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-06
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy