Provider Demographics
NPI:1770855629
Name:UNRUH, WALT JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WALT
Middle Name:JOHN
Last Name:UNRUH
Suffix:
Gender:M
Credentials:PHARMD
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Other - Credentials:
Mailing Address - Street 1:600 CAISSON HILL ROAD
Mailing Address - Street 2:IRWIN COMMUNITY HOSPITAL, DEPARTMENT OF PHARMACY
Mailing Address - City:FT. RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442
Mailing Address - Country:US
Mailing Address - Phone:785-239-7411
Mailing Address - Fax:785-239-7239
Practice Address - Street 1:600 CAISSON HILL ROAD
Practice Address - Street 2:IRWIN COMMUNITY HOSPITAL, DEPARTMENT OF PHARMACY
Practice Address - City:FT. RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-7037
Practice Address - Country:US
Practice Address - Phone:785-239-7411
Practice Address - Fax:785-239-7239
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX41898183500000X
KS1-13147183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist