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NPI Code Detail

MEDICARE: KATHERINE DENISE WALL RPH

MEDICARE:   KATHERINE DENISE WALL  RPH
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
1183500000XPharmacist10160NC

General Provider Information

NPI Number : 1265429120
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE DENISE WALL RPH
Provider Business Mailing Address
First Line : 754 OLDE THOMPSON CREEK RD
Second Line :
City : APEX
State : NC
Zip : 27523-4796
Country : US
Telephone Number : 919-303-4642
Fax Number :
Provider Business Practice Location Address
First Line : 3643 N ROXBORO ST
Second Line : DURHAM REGIONAL HOSPITAL
City : DURHAM
State : NC
Zip : 27704-2702
Country : US
Telephone Number : 919-470-4168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 07/08/2007

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Directions to “ KATHERINE DENISE WALL RPH” Practice Location

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