Waltmoor Corp
Waltmoor Corp is a healthcare organization registered as Community/Retail Pharmacy in Middlesboro, KY, holding Type 2 (organization) NPI 1154479152 since 2007. The authorized official on file is Trent Walters, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1154479152 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Waltmoor Corp |
| Other name | <Unavail> |
| Practice address | 3603 CUMBERLAND AVE, Middlesboro, KY, 40965 |
| Phone | 6062488900 |
| Fax | 6062488901 |
| Enumeration date | 2007-01-08 |
| Last updated in NPPES | 2010-04-01 |
Authorized official
| Name | Trent Walters |
|---|---|
| Title | Owner |
| Phone | 6062488900 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 007132 | KY |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1813787 | Other | — | NCPDP PROVIDER IDENTIFICATION NUMBER |
| 1813787 | Medicaid | TN | — |
| 54017041 | Medicaid | KY | — |
Copy-ready billing details
Provider: Waltmoor Corp NPI: 1154479152 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 3603 CUMBERLAND AVE, Middlesboro, KY, 40965
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1154315075 | Jeremiah Brooks | Individual | Internal Medicine Physician | Middlesboro, KY |
| 1144502287 | Family Discount Drugs | Organization | Community/Retail Pharmacy | Middlesboro, KY |
| 1275140840 | Robert Marcum | Individual | Pharmacist | Middlesboro, KY |
Verify this record
Cross-check NPI 1154479152 against the authoritative CMS record: view Waltmoor Corp on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Waltmoor Corp located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2010-04-01.