Organization
SCOTT VALLEY PHARMACY INC
Active
Organization
SCOTT VALLEY PHARMACY INC
Active
Other names
Scott Valley Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TODD (CEO)
(541) 941-4032
Entity
Organization
Contact information
Practice address
511 MAIN STREET, ETNA, CA 96027-0610
(530) 467-5335
(530) 467-5111
Mailing address
PO BOX 610, ETNA, CA 96027-0610
(530) 467-5335
(530) 467-5111
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50463
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0554306
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA369010
—
CA
Enumeration date
10/17/2006
Last updated
12/14/2010
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