Organization
GREEN VALLEY PHARMACY LLC
Active
Other names
Green Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SYLVIA MOC CPA (OWNER/CFO/AO)
(909) 980-0999
Entity
Organization
Contact information
Practice address
33733 YUCAIPA BLVD STE 1, YUCAIPA, CA 92399-2256
(909) 980-0999
(909) 980-1099
Mailing address
8237 ROCHESTER AVE STE 120, RANCHO CUCAMONGA, CA 91730-0717
(909) 980-0999
(909) 980-1099
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
54475
CA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699122002
—
CA
Enumeration date
05/17/2016
Last updated
04/12/2022
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