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General NPI Number Information
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NPI Number | 1659836179
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Entity Type | Organization
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Legal Business Name | WALHEALTH LLC
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 17860 SE 109TH AVE STE 616A
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8909
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Country | US
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Telephone | 352-775-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 17860 SE 109TH AVE STE 616A
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City | SUMMERFIELD
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State | FL
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Zip | 34491-8909
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Country | US
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Telephone | 352-775-0888
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PETER B SHEHATA
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Credential | RPH
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Telephone | 352-775-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail 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 | 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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