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Organization
NIKKI R WALTERS
Active
Organization
NIKKI R WALTERS
Active
Other names
WARD'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKKI RED WALTERS (OWNER)
(601) 477-8587
Entity
Organization
Contact information
Practice address
122 S FRONT ST, ELLISVILLE, MS 39437-3118
(601) 477-8587
(601) 477-3222
Mailing address
122 S FRONT ST, ELLISVILLE, MS 39437-3118
(601) 477-8587
(601) 477-3222
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-03592
MS
3336C0003X
Community/Retail Pharmacy
Primary
0013001.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330679
—
MS
Enumeration date
09/22/2006
Last updated
06/16/2008
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