Provider Demographics
NPI:1871599589
Name:WALKER, EDWARD JOSEPH (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:WALKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:IN
Mailing Address - Zip Code:47882-7201
Mailing Address - Country:US
Mailing Address - Phone:812-268-0546
Mailing Address - Fax:
Practice Address - Street 1:13 W JACKSON ST
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:IN
Practice Address - Zip Code:47882-1503
Practice Address - Country:US
Practice Address - Phone:812-268-4737
Practice Address - Fax:812-268-9707
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist