Organization
WALLYS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS L HAMILTON (PRES)
(336) 799-9089
Entity
Organization
Contact information
Practice address
933 OLD ROCKFORD ST, MOUNT AIRY, NC 27030-5356
(336) 789-9089
(336) 789-1161
Mailing address
933 OLD ROCKFORD ST, MOUNT AIRY, NC 27030-5356
(336) 789-9089
(336) 789-1161
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5393
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0865469
—
NC
Enumeration date
01/24/2007
Last updated
01/12/2024
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