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Organization
WALTERS PHARMACY INC
Active
Organization
WALTERS PHARMACY INC
Active
Other names
Walter's Pharmacy, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KOEHN RPH (PIC)
(979) 865-3696
Entity
Organization
Contact information
Practice address
250 W PALM ST, BELLVILLE, TX 77418-1361
(979) 865-3696
(979) 865-3697
Mailing address
250 W PALM ST, BELLVILLE, TX 77418-1361
(979) 865-3696
(979) 865-3697
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05941
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142084
—
TX
01
—
2099889
PK
—
Enumeration date
01/08/2007
Last updated
11/04/2014
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