Organization
WALMART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER HAISLIP DANIEL (PHARMACIST)
(252) 535-1170
Entity
Organization
Contact information
Practice address
251 PREMIER BLVD, ROANOKE RAPIDS, NC 27870-5076
(252) 535-1170
Mailing address
251 PREMIER BLVD, ROANOKE RAPIDS, NC 27870-5076
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
24306
NC
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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