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General NPI Number Information
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NPI Number | 1366445827
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Entity Type | Organization
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Legal Business Name | WALTERS PHARMACY INC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 02/20/2017
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Provider Practice Location Address
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Address Line | 401 N 17TH ST SUITE 102
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City | ALLENTOWN
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State | PA
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Zip | 18104-5034
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Country | US
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Telephone | 610-435-4706
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Fax | 610-435-2107
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Provider Business Mailing Address
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Address Line | 401 N 17TH ST SUITE 102
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City | ALLENTOWN
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State | PA
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Zip | 18104-5034
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Country | US
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Telephone | 610-435-4706
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Fax | 610-435-2107
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Authorized Official
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Title or Position | OWNER
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Name | HOWARD ANTHONY
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Credential | RPH
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Telephone | 610-435-4706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP412814L
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License Number State | PA
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