Healthcare Provider Details

I. General information

NPI: 1669564134
Provider Name (Legal Business Name): WALKER DRUG COMPANY OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 N 7TH ST
GRAND JUNCTION CO
81501-7423
US

IV. Provider business mailing address

2241 N 7TH ST
GRAND JUNCTION CO
81501-7423
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-9303
  • Fax: 970-242-0007
Mailing address:
  • Phone: 970-243-9303
  • Fax: 970-242-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number04239710000
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JACK WALKER
Title or Position: PRESIDENT AND OWNER
Credential: RPH
Phone: 970-243-9303