Provider Demographics
NPI:1659836179
Name:WALHEALTH LLC
Entity type:Organization
Organization Name:WALHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHEHATA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:352-775-0888
Mailing Address - Street 1:17860 SE 109TH AVE STE 616A
Mailing Address - Street 2:
Mailing Address - City:SUMMERFIELD
Mailing Address - State:FL
Mailing Address - Zip Code:34491-8909
Mailing Address - Country:US
Mailing Address - Phone:352-775-0888
Mailing Address - Fax:
Practice Address - Street 1:17860 SE 109TH AVE STE 616A
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8909
Practice Address - Country:US
Practice Address - Phone:352-775-0888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WALHEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy