Provider Demographics
NPI:1225637424
Name:WALKER, MILAGROS H (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:H
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 LINDHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3765
Mailing Address - Country:US
Mailing Address - Phone:228-224-2767
Mailing Address - Fax:
Practice Address - Street 1:2119 LINDHRIDGE DR
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3765
Practice Address - Country:US
Practice Address - Phone:228-224-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist