Willow Valley Pharmacy, Inc., Dba

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY33276 Issued in CA

Legal business name

WILLOW VALLEY PHARMACY, INC., DBA

Practice address

1101 W Broadway St
Needles, CA 92363-2704

Phone

(760) 326-2312

Fax

(760) 326-4178

NPI assigned

Sep 26, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Richard B Pocock, PHARM.D.

Title

Responsible Pharmacist

Phone

(760) 326-2312

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• NEEDLES POINT PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437145299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W BROADWAY ST",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923632704",
            "telephone_number": "760-326-2312",
            "fax_number": "760-326-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W BROADWAY ST",
            "city": "NEEDLES",
            "state": "CA",
            "postal_code": "923632704",
            "telephone_number": "760-326-2312",
            "fax_number": "760-326-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW VALLEY PHARMACY, INC., DBA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POCOCK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "RESPONSIBLE PHARMACIST",
        "authorized_official_telephone_number": "760-326-2312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY33276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA332760",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "05-87482",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEEDLES POINT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Needles, CA
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.