Organization
PROFESSIONAL PHARMACY, INC.
Active
Other names
Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROD WAECKERLIN (OWNER/RPH)
(307) 320-8482
Entity
Organization
Contact information
Practice address
101 CONSTITUTION AVE., SARATOGA, WY 82331
(307) 326-5129
(307) 326-5165
Mailing address
PO BOX 683, SARATOGA, WY 82331-0683
(307) 326-5165
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
52-03120
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111302000
—
WY
01
—
2111536
PK
—
Enumeration date
02/08/2007
Last updated
02/10/2022
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