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General NPI Number Information
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NPI Number | 1972546125
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Entity Type | Organization
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Legal Business Name | WALKER PHARMACY AND GIFTS, INC.
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2425 NORTHSIDE DR W
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City | STATESBORO
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State | GA
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Zip | 30458-2153
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Country | US
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Telephone | 912-764-6715
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Fax | 912-489-4649
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Provider Business Mailing Address
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Address Line | PO BOX 2087
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City | STATESBORO
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State | GA
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Zip | 30459-2087
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Country | US
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Telephone | 912-764-6715
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Fax | 912-489-4649
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORDAN DENT WALKER
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Credential | PHARMD
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Telephone | 912-681-3784
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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 | 6365
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License Number State | GA
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