Provider Demographics
NPI:1538467741
Name:WAL-MED PHARMACY INC
Entity Type:Organization
Organization Name:WAL-MED PHARMACY INC
Other - Org Name:DUNAMIS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELPHINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMUNEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-344-8475
Mailing Address - Street 1:6611 CHIMNEY ROCK RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5356
Mailing Address - Country:US
Mailing Address - Phone:713-661-3600
Mailing Address - Fax:713-661-3601
Practice Address - Street 1:6611 CHIMNEY ROCK RD STE 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5338
Practice Address - Country:US
Practice Address - Phone:713-661-3600
Practice Address - Fax:713-661-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
TX277573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5904671OtherNCPDP PROVIDER IDENTIFICATION NUMBER