Wallys Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5393 Issued in NC

Legal business name

WALLYS PHARMACY INC

Practice address

933 Old Rockford St
Mount Airy, NC 27030-5356

Phone

(336) 789-9089

Fax

(336) 789-1161

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Thomas L HamiltonNPI 1942229497

Title

Pres

Phone

(336) 799-9089

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Lin Hamilton IV

  • Pharmacist
  • Mount Airy, NC
  • NPI 1942229497
  NPD Authorized official
• Jessica Stroupe Scott, PHARMD

  • Pharmacist
  • Mount Airy, NC
  • NPI 1427208131
  NPD
• Molly Christine Hamilton, MD

  • Family Medicine Physician
  • Eden, NC
  • NPI 1346860848
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1285789024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 OLD ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305356",
            "telephone_number": "336-789-9089",
            "fax_number": "336-789-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 OLD ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305356",
            "telephone_number": "336-789-9089",
            "fax_number": "336-789-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLYS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "336-799-9089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "5393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0865469",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Walgreen Co
• Michael Wayne Wall, LPC
• Michelle Deanna Wall, PA-C
• Wallys Clinical Services LLC
• Jill Warren, OTR/L
• Brittany Dejrune' Watson
• Daniel Dean Watson, NP
• Jennifer B Watson, PTA
• Amber Welborn

• Community/Retail Pharmacy in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.