Valley Man LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VALLEY MAN LLC

Doing business as

Medicine Man Pharmacy

Practice address

123 E Gardiner St
Valley, NE 68064-9798

Phone

(402) 359-2284

NPI assigned

Jun 8, 2021

Last updated

Jun 8, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

BP INCAs reported in NPPES

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

Authorized official

Name

Jed Lewis, PHARMD

Title

Vice President

Phone

(402) 652-3217

Specialties & licenses 3

Addresses

Other names 1

• Medicine Man Pharmacy Doing business as

Part of

Medicine Man Pharmacy DME

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623110400000",
    "number": "1902473994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "city": "NORTH BEND",
            "state": "NE",
            "postal_code": "686490437",
            "telephone_number": "402-652-3217",
            "fax_number": "402-652-8219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E GARDINER ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680649798",
            "telephone_number": "402-359-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY MAN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BP INC",
        "enumeration_date": "2021-06-08",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JED",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "402-652-3217",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Man Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Valley, NE
• Providers in Valley, NE by specialty
• Community/Retail Pharmacy in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.