Provider Demographics
NPI:1497902753
Name:WALKER, THOMAS (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 RICHLANDS HWY
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574
Mailing Address - Country:US
Mailing Address - Phone:910-324-1656
Mailing Address - Fax:910-324-2253
Practice Address - Street 1:9005 RICHLANDS HIGHWAY
Practice Address - Street 2:
Practice Address - City:RICHLANDS
Practice Address - State:NC
Practice Address - Zip Code:28574
Practice Address - Country:US
Practice Address - Phone:910-324-1656
Practice Address - Fax:910-324-2253
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist