Organization
STAR VALLEY DRUG CO
Active
Other names
VALLEY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL STAUFFER (PRESIDENT)
(307) 885-9804
Entity
Organization
Contact information
Practice address
439 WASHINGTON, AFTON, WY 83110-0099
(307) 885-9804
(307) 885-9760
Mailing address
PO BOX 99, AFTON, WY 83110-0099
(307) 885-9804
(307) 885-9760
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5200059
WY
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5200059
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/06/2006
Last updated
02/15/2008
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