Provider Demographics
NPI:1588281588
Name:WALSTON, CHRISTOPHER JORDAN (PHARMD, BCACP)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JORDAN
Last Name:WALSTON
Suffix:
Gender:M
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 MCLEANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9716
Mailing Address - Country:US
Mailing Address - Phone:919-441-8494
Mailing Address - Fax:
Practice Address - Street 1:1021 PINE PLAZA DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27523-6406
Practice Address - Country:US
Practice Address - Phone:919-331-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-25
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC296171835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care