Organization
VALLEY LAKE INC
Active
Other names
Green Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AKUWUDIKE JOHN ANOZIE (PRESIDENT/CEO/PHARMACIST)
(702) 565-3374
Entity
Organization
Contact information
Practice address
2245 N GREEN VALLEY PKWY, HENDERSON, NV 89014-5024
(702) 565-3374
(702) 565-3377
Mailing address
2245 N GREEN VALLEY PKWY, HENDERSON, NV 89014-5024
(702) 565-3374
(702) 565-3377
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH03781
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121178
PK
—
Enumeration date
07/22/2009
Last updated
07/21/2022
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