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General NPI Number Information
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NPI Number | 1801935259
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Entity Type | Organization
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Legal Business Name | WALKER HOME MEDICAL
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 BRAMPTON AVE STE 1F
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City | STATESBORO
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State | GA
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Zip | 30458-0827
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Country | US
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Telephone | 912-681-3838
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Fax | 912-681-3839
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Provider Business Mailing Address
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Address Line | 100 BRAMPTON AVE STE 1F
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City | STATESBORO
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State | GA
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Zip | 30458-0827
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Country | US
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Telephone | 912-681-3838
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Fax | 912-681-3839
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JESSICA PENNINGTON
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Credential | CTRS
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Telephone | 912-681-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHRE008665
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License Number State | GA
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