Walters Pharmacy Shoppe
LBN: Waltmoor Corp
Walters Pharmacy Shoppe is an health care organization with primary practice located at 3603 Cumberland Ave , Middlesboro KY 40965-2613. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Waltmoor Corp can be contacted via phone (606) 248-8900, or through Walters, Trent via phone (606) 248-8900.
Contact Information
Primary practice address
3603 Cumberland Ave
Middlesboro KY 40965-2613
Phone: (606) 248-8900
Fax: (606) 248-8901
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 007132 | Kentucky |
Profile Details
| NPI number | 1154479152 |
|---|---|
| LBN Legal business name | Waltmoor Corp |
| DBA Doing business as | Walters Pharmacy Shoppe |
| Authorized official | Walters, Trent |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Apr 1st, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154479152 | NPPES |
| Other | 1813787 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 1813787 | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| MEDICAID | 54017041 | NCPDP PROVIDER IDENTIFICATION NUMBER |
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