Provider Demographics
NPI:1669532693
Name:WALKER PHARMACY AND GIFTS, INC.
Entity type:Organization
Organization Name:WALKER PHARMACY AND GIFTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:DENT
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-681-3784
Mailing Address - Street 1:160 S VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:GA
Mailing Address - Zip Code:30436-1444
Mailing Address - Country:US
Mailing Address - Phone:912-526-8531
Mailing Address - Fax:912-526-0248
Practice Address - Street 1:160 S VICTORY DR
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:GA
Practice Address - Zip Code:30436-1444
Practice Address - Country:US
Practice Address - Phone:912-526-8531
Practice Address - Fax:912-526-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111525OtherNABP #
GA000029664AMedicaid
GADEAOtherFW1236973