Healthcare Provider Details

I. General information

NPI: 1699492058
Provider Name (Legal Business Name): WALKERS SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2022
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8145 ARDREY KELL RD STE 105
CHARLOTTE NC
28277-5721
US

IV. Provider business mailing address

4123 HICKORY VIEW DR
INDIAN LAND SC
29707-1527
US

V. Phone/Fax

Practice location:
  • Phone: 704-321-0027
  • Fax:
Mailing address:
  • Phone: 704-608-1721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NIRAV PATEL
Title or Position: PHARMACY MANAGER
Credential: PHARMACIST
Phone: 704-608-1721