Walton Drug Co Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE004488 Issued in GA

Legal business name

WALTON DRUG CO INC

Practice address

150 MKL Jr Blvd
Suite a
Monroe, GA 30655

Phone

(770) 267-2559

Fax

(770) 267-6138

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Wanda Hickman

Title

Owner, Ao

Phone

(770) 267-2559

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Jennifer Cown, PHARMD

  • Pharmacist
  • Monroe, GA
  • NPI 1215580311
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1932217866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 965",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306550965",
            "telephone_number": "770-267-2559",
            "fax_number": "770-267-6138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MKL JR BLVD",
            "address_2": "SUITE A",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "30655",
            "telephone_number": "770-267-2559",
            "fax_number": "770-267-6138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTON DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "OWNER,  AO",
        "authorized_official_telephone_number": "770-267-2559"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE004488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00329667A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2012680",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laquesha Walker
• Walton Anesthesia Associates, PC
• Walton County School System
• Walton County Senior Center
• Walton Drug Co Inc
• Walton Eye Care, Inc.
• Walton Family Dentistry LLC
• Walton Family Medicine, P.C.
• Walton Hospitalist Associates
• Zhe Wang, LAPC

• Community/Retail Pharmacy in Monroe, GA
• Providers in Monroe, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.