Waller'S Discount Drugs, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00269 Issued in MS

Legal business name

WALLER'S DISCOUNT DRUGS, INC.

Practice address

2209 S Lamar Blvd
Oxford, MS 38655-5225

Phone

(662) 234-6315

NPI assigned

Mar 16, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel W. Waller

Title

President

Phone

(662) 234-6315

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083738207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555225",
            "telephone_number": "662-234-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER'S DISCOUNT DRUGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-234-6315"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00400315",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Reed Wallace, CCC-SLP
• Ashlee Wallace, RN
• David R Wallace, PT
• Walter Moore Wallace, L.C.S.W.
• Jason Waller, DO
• Ryan Shelton Wally, O.D.
• Joshua M Walston
• Marc E Walters, PCMHT
• Shelby R Walters, MD
• Charles Patrick Ward, P-LPC

• Community/Retail Pharmacy in Oxford, MS
• Providers in Oxford, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.