Healthcare Provider Details

I. General information

NPI: 1356579072
Provider Name (Legal Business Name): WALLIER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 PITT ST STE 102
SHARON PA
16146-2102
US

IV. Provider business mailing address

343 MERCER RD
GREENVILLE PA
16125-9773
US

V. Phone/Fax

Practice location:
  • Phone: 724-347-7000
  • Fax: 724-347-7007
Mailing address:
  • Phone: 724-885-0310
  • Fax: 724-885-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP481902
License Number StatePA

VIII. Authorized Official

Name: BRETTON WALBERG
Title or Position: OWNER/RPH
Credential:
Phone: 724-612-2131