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Organization
WALNUT COVE PHARMACY INC
Active
Organization
WALNUT COVE PHARMACY INC
Active
Other names
FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD WATTS RPH (OWNER)
(336) 591-7171
Entity
Organization
Contact information
Practice address
317 N MAIN ST, WALNUT COVE, NC 27052-9200
(336) 591-7171
(336) 591-7936
Mailing address
PO BOX 537, WALNUT COVE, NC 27052-0537
(336) 591-7171
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5086
NC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0855148
—
NC
01
—
3416321
OTHER ID NUMBER
—
01
—
Q492110001
MEDICARE PTAN
NC
Enumeration date
09/26/2006
Last updated
10/26/2016
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