Organization
PERIGON PHARMACY 360, LLC
Active
Other names
Valeda Rx LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GENESE MARIE HENDRICKSON (CHIEF EXECUTIVE OFFICER)
(412) 684-2500
Entity
Organization
Contact information
Practice address
1120 STEVENSON MILL RD STE 200, CORAOPOLIS, PA 15108-2446
(412) 684-2500
(844) 582-5332
Mailing address
1120 STEVENSON MILL RD STE 200, CORAOPOLIS, PA 15108-2446
(844) 698-2533
(844) 582-5332
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1032363790001
—
PA
05
—
1669823266
—
CO
05
—
1689851
—
AK
05
—
2111445
—
WA
01
—
2160783
PK
—
05
—
564121700
—
MD
05
—
656739
—
NJ
05
—
7P2679
—
SC
Enumeration date
06/24/2016
Last updated
01/09/2023
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