Provider Demographics
NPI:1104159607
Name:WALTER'S PHARMACY INC.
Entity type:Organization
Organization Name:WALTER'S PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:HARCOURT
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:510-533-2700
Mailing Address - Street 1:2700 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-1520
Mailing Address - Country:US
Mailing Address - Phone:510-533-2700
Mailing Address - Fax:415-242-1492
Practice Address - Street 1:2700 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 32
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1520
Practice Address - Country:US
Practice Address - Phone:510-533-2700
Practice Address - Fax:415-242-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy