Organization
VALLEY DRUG CO
Active
Other names
Lake Spokane Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN HERDA (OWNER)
(509) 935-8611
Entity
Organization
Contact information
Practice address
5919 HIGHWAY 291 STE 5, NINE MILE FALLS, WA 99026-9525
(509) 935-8611
(509) 935-6983
Mailing address
PO BOX 107, CHEWELAH, WA 99109-0107
(509) 935-8611
(509) 935-6983
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
60157204
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4933734
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/07/2010
Last updated
07/07/2010
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