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NPI Code Detail

MEDICARE: TAYLOR MARIE WALSH PHARMD

MEDICARE: TAYLOR MARIE WALSH PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist42270SC
2183500000XPharmacist29093NC

General Provider Information

NPI Number : 1225687361
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MARIE WALSH PHARMD
Provider Business Mailing Address
First Line : 4390 COLWICK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-2310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4390 COLWICK RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-2310
Country : US
Telephone Number : 704-364-3444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2019
Last Update Date : 09/11/2019

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