Healthcare Provider Details

I. General information

NPI: 1265026850
Provider Name (Legal Business Name): LAUREN WALKER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAUREN HINDS

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 02/24/2021
Certification Date: 02/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 S GLOSTER ST
TUPELO MS
38801-4996
US

IV. Provider business mailing address

205 OAK ST
NEW ALBANY MS
38652-3715
US

V. Phone/Fax

Practice location:
  • Phone: 662-377-3000
  • Fax:
Mailing address:
  • Phone: 662-255-0005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-15479
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: