Organization
WALMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD KELLY ALTMAN II PHARM.D (REGIONAL DIRECTOR)
(479) 586-3101
Entity
Organization
Contact information
Practice address
9600 PARKSOUTH CT, ORLANDO, FL 32837-6424
(479) 586-3101
Mailing address
9600 PARKSOUTH CT, ORLANDO, FL 32837-6424
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PS 50266
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS 50266
FLORIDA PHARMACIST LICENSE
FL
Enumeration date
07/11/2013
Last updated
07/11/2013
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