Organization
URBAN DRUG STORE INC
Active
Organization
URBAN DRUG STORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERMIT LAMAR WALTERS JR. MD (PRESIDENT)
(318) 388-1374
Entity
Organization
Contact information
Practice address
1910 JACKSON ST, MONROE, LA 71202-2532
(318) 388-1374
(318) 398-0888
Mailing address
1910 JACKSON ST, MONROE, LA 71202-2532
(318) 388-1374
(318) 398-0888
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2328IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1259136
—
LA
01
—
1921938
NABP
—
01
—
2328IR
LICENSE
LA
Enumeration date
09/20/2006
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up