# WALTON DRUG CO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932217866
- **Authorized official:** WANDA HICKMAN (OWNER, AO)
- **Authorized official phone:** (770) 267-2559

## Contact information

- **Practice address:** 150 MKL JR BLVD, SUITE A, MONROE, GA 30655
- **Practice address phone:** (770) 267-2559
- **Practice address fax:** (770) 267-6138
- **Mailing address:** PO BOX 965, MONROE, GA 30655-0965
- **Mailing address phone:** (770) 267-2559
- **Mailing address fax:** (770) 267-6138

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WD0400X | Diabetes Educator Registered Nurse | — | NULL | — |
| 163WD0400X | Diabetes Educator Registered Nurse | — | — | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE004488 | GA | Yes |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 08/02/2019