Organization
VALLEY PROFESSIONAL PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NEIL STODDARD (OWNER PHARMACIST)
(208) 356-6534
Entity
Organization
Contact information
Practice address
234 E 1ST N, REXBURG, ID 83440-1616
(208) 356-6534
(208) 356-6390
Mailing address
234 E 1ST N, REXBURG, ID 83440-1616
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
1772CP
ID
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1304980
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/04/2005
Last updated
09/11/2025
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