Provider Demographics
NPI:1235648411
Name:VALLEY PHARMACY INC
Entity type:Organization
Organization Name:VALLEY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:VOGT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:402-359-2284
Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:VALLEY
Mailing Address - State:NE
Mailing Address - Zip Code:68064-0500
Mailing Address - Country:US
Mailing Address - Phone:402-359-2284
Mailing Address - Fax:402-727-2316
Practice Address - Street 1:PO BOX 500
Practice Address - Street 2:
Practice Address - City:VALLEY
Practice Address - State:NE
Practice Address - Zip Code:68064-0500
Practice Address - Country:US
Practice Address - Phone:402-359-2284
Practice Address - Fax:402-727-2316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VOGT PHARMACIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3101333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3101OtherSTATE LICENSE
NE2811051OtherNCPDP