Valley Lake Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH03781 Issued in NV

Legal business name

VALLEY LAKE INC

Doing business as

Green Valley Pharmacy

Practice address

2245 N Green Valley Pkwy
Henderson, NV 89014-5024

Phone

(702) 565-3374

Fax

(702) 565-3377

NPI assigned

Jul 22, 2009

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Akuwudike John Anozie

Title

President/Ceo/Pharmacist

Phone

(702) 565-3374

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Green Valley Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1982834131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890145024",
            "telephone_number": "702-565-3374",
            "fax_number": "702-565-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N GREEN VALLEY PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890145024",
            "telephone_number": "702-565-3374",
            "fax_number": "702-565-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY LAKE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ANOZIE",
        "authorized_official_first_name": "AKUWUDIKE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO/PHARMACIST",
        "authorized_official_telephone_number": "702-565-3374"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH03781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2121178",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Valley Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Henderson, NV
• Providers in Henderson, NV by specialty
• Community/Retail Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.