1164590964 NPI number — WALKERS PHARMACY INC

Table of content: KATHERINE ASHLEY CAREY LPC (NPI 1679236715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164590964 NPI number — WALKERS PHARMACY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WALKERS PHARMACY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164590964
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 127
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTON
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28658-0127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 N COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28658-3235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-464-1240
Provider Business Practice Location Address Fax Number:
828-464-1218
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER AND PHARM
Authorized Official Telephone Number:
828-464-1222

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: 11447 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0185744 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2070103 . This is a "PK" identifier . This identifiers is of the category "OTHER".




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