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General NPI Number Information
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NPI Number | 1407569791
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Entity Type | Individual
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Provider Name | IAN WALSH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 01/02/2023
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Provider Practice Location Address
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Address Line | 639 NUWAY CIR
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City | LENOIR
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State | NC
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Zip | 28645-3646
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Country | US
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Telephone | 828-759-7343
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Fax |
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Provider Business Mailing Address
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Address Line | 460 PALISADES DR
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City | LINCOLNTON
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State | NC
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Zip | 28092-0026
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Country | US
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Telephone | 980-333-5169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31268
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License Number State | NC
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