Organization
WALNUT SQUARE PHARMACY LLC
Active
Other names
WALNUT SQUARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN WORREL PHARMD (CFO)
(601) 583-3232
Entity
Organization
Contact information
Practice address
124 WALNUT CIR, STE 3, HATTIESBURG, MS 39401-3500
(601) 543-0111
(601) 543-0208
Mailing address
124 WALNUT CIR, STE 3, HATTIESBURG, MS 39401-3500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05515011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330691
—
MS
01
—
2521082
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/07/2007
Last updated
09/12/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us