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NPI Code Detail

MEDICARE: JOE R WALKER PHARM D

MEDICARE: JOE R WALKER PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist1371440WI

General Provider Information

NPI Number : 1790062255
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOE R WALKER PHARM D
Provider Business Mailing Address
First Line : 6700 144TH AVE
Second Line :
City : KENOSHA
State : WI
Zip : 53142-8807
Country : US
Telephone Number : 262-880-3635
Fax Number :
Provider Business Practice Location Address
First Line : 7600 W CAPITOL DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-2055
Country : US
Telephone Number : 414-464-4601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2011
Last Update Date : 11/11/2011

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