Organization
VALLEY COMPOUNDING PHARMACY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES VINCENT ETTARE II PHARMD (PRESIDENT)
(434) 237-3331
Entity
Organization
Contact information
Practice address
22776 TIMBERLAKE RD, SUITE C, LYNCHBURG, VA 24502-7310
(434) 237-3331
Mailing address
2201 LANGHORNE RD, SUITE A, LYNCHBURG, VA 24501-1124
(434) 237-3331
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
0201004203
VA
Other
Enumeration date
02/07/2008
Last updated
10/14/2010
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