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General NPI Number Information
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NPI Number | 1538146071
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Entity Type | Organization
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Legal Business Name | WALNUT HILL PHARMACY INC
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1950 S SYCAMORE ST
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City | PETERSBURG
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State | VA
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Zip | 23805
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Country | US
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Telephone | 804-733-7711
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Fax | 804-733-8819
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Provider Business Mailing Address
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Address Line | 1950 S SYCAMORE ST
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City | PETERSBURG
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State | VA
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Zip | 23805
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Country | US
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Telephone | 804-733-7711
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Fax | 804-733-8819
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | MR. THOMAS FELIX LEE
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Credential | RPH
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Telephone | 804-733-7711
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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 | 0201001813
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License Number State | VA
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