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Organization
WALTON DRUG CO INC
Active
Organization
WALTON DRUG CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA HICKMAN (OWNER, AO)
(770) 267-2559
Entity
Organization
Contact information
Practice address
150 MKL JR BLVD, SUITE A, MONROE, GA 30655
(770) 267-2559
(770) 267-6138
Mailing address
PO BOX 965, MONROE, GA 30655-0965
(770) 267-2559
(770) 267-6138
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
NULL
163WD0400X
Diabetes Educator Registered Nurse
—
—
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE004488
GA
Other
Enumeration date
08/29/2006
Last updated
08/02/2019
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