Organization
COACHELLA VALLEY PHARMACY, INC
Active
Other names
Coachella Valley Pharmacy, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
PEACHY LUA (CEO / PIC)
(760) 223-7188
Entity
Organization
Contact information
Practice address
77932 COUNTRY CLUB DR, STE #2-2, PALM DESERT, CA 92211-3407
(760) 223-7188
(760) 223-7187
Mailing address
77932 COUNTRY CLUB DR, STE #2-2, PALM DESERT, CA 92211-3407
(760) 223-7188
(760) 223-7187
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY54524
CA
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2162354
PK
—
Enumeration date
07/23/2016
Last updated
09/19/2025
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