| Doctor Name: | MR. WALTER THOMAS DAMERON |
| NPI Number: | 1538313689 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPH |
| License Number: | 6650 |
| Business Practice Address: | 217 Lucerne Blvd Birmingham, AL - 352096613 |
| Business Phone Number: | 2058792759 |
| Business Fax Number: | |
| Mailing Address: | 217 Lucerne Blvd, BIRMINGHAM |
| State: | AL |
| Postal Code: | 352096613 |
| Phone Number: | 2058792759 |
| Fax Number: | |
| NPI Enumeration Date: | 11/14/2008 |
| NPI Last Update Date: | 11/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 333600000X |
| License Number: | 6650 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |