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General NPI Number Information
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NPI Number | 1942363171
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Entity Type | Individual
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Provider Name | WILLIAM HENRY WALTER RPH
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Gender | Male
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2210 SUNRISE BLVD PRICELESS DRUG STORE
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-4377
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Country | US
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Telephone | 916-638-0214
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Fax | 916-638-2513
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Provider Business Mailing Address
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Address Line | 4377 TOMMY CT
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City | RESCUE
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State | CA
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Zip | 95672
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Country | US
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Telephone | 530-677-2930
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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 | RPH29382
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6043
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License Number State | OR
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