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General NPI Number Information
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NPI Number | 1861545113
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Entity Type | Organization
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Legal Business Name | WALL DRUGS OF FLORENCE, INC.
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 1337 S IRBY ST STE A
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City | FLORENCE
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State | SC
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Zip | 29505-2784
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Country | US
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Telephone | 843-667-0759
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Fax | 843-667-0506
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Provider Business Mailing Address
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Address Line | 1337 S IRBY ST STE A
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City | FLORENCE
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State | SC
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Zip | 29505-2784
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. DERRICK ALLAN WALL
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Credential | RPH
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Telephone | 843-667-0759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 50007436
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License Number State | SC
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