Organization
VALLE VERDE PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS F DEMBSKI JR. (VICE PRESIDENT)
(831) 426-0200
Entity
Organization
Contact information
Practice address
240 GREEN VALLEY RD, FREEDOM, CA 95019-3137
(831) 728-2239
(831) 728-9386
Mailing address
240 GREEN VALLEY RD, FREEDOM, CA 95019-3137
(831) 728-2239
(831) 728-9386
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY21728
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-67644
NABP
CA
05
—
PHA217280
—
CA
01
—
PHY21728
STATE PHARMACY LIC
CA
Enumeration date
02/01/2007
Last updated
08/22/2020
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