Provider Demographics
NPI:1396755401
Name:HOSPITAL PHARMACY OF WASHINGTON INC
Entity type:Organization
Organization Name:HOSPITAL PHARMACY OF WASHINGTON INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALTON
Authorized Official - Middle Name:P
Authorized Official - Last Name:ONEAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:252-943-2643
Mailing Address - Street 1:601 EAST 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889
Mailing Address - Country:US
Mailing Address - Phone:252-946-4113
Mailing Address - Fax:252-946-9552
Practice Address - Street 1:601 EAST 12TH STREET
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889
Practice Address - Country:US
Practice Address - Phone:252-946-4113
Practice Address - Fax:252-946-9552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1809333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0075259Medicaid
NC7700839OtherMEDICAID DME
NC0269580001Medicare ID - Type Unspecified