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General NPI Number Information
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NPI Number | 1376085001
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Entity Type | Organization
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Legal Business Name | WALMART PHARMACY
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Dates
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Enumeration Date | 11/11/2016
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Last Update Date | 11/11/2016
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Provider Practice Location Address
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Address Line | 1801 US HIGHWAY 421
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City | WILKESBORO
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State | NC
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Zip | 28697-2279
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Country | US
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Telephone | 336-667-4337
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 US HIGHWAY 421
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City | WILKESBORO
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State | NC
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Zip | 28697-2279
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Country | US
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Telephone | 336-667-4337
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | DR. CHRISTOPHER LEE BENNETT
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Credential |
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Telephone | 336-667-4337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 17411
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License Number State | NC
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