Organization
VALENTINE PHARMACY INC
Active
Other names
VALENTINE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RHONNY VALENTINE (OWNER)
(318) 872-5300
Entity
Organization
Contact information
Practice address
116 JEFFERSON ST, MANSFIELD, LA 71052-2602
(318) 872-5300
(318) 872-5380
Mailing address
PO BOX 1619, MANSFIELD, LA 71052-1619
(318) 872-5300
(318) 872-3968
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2720
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1261076
—
LA
01
—
1924821
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
01/28/2011
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