# ANDERSON DISTRICT 4

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922345164
- **Authorized official:** MRS. KRISTI WALTERS MARTIN R.N. (REGISTERED NURSE)
- **Authorized official phone:** (864) 403-2400

## Contact information

- **Practice address:** 2850 LEBANON RD, PENDLETON, SC 29670-9482
- **Practice address phone:** (864) 403-2400
- **Practice address fax:** (864) 716-3654
- **Mailing address:** 2850 LEBANON RD, PENDLETON, SC 29670-9482
- **Mailing address phone:** (864) 403-2400
- **Mailing address fax:** (864) 716-3654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WS0200X | School Registered Nurse | 62308 | SC | Yes |

## Other

- **Enumeration date:** 01/08/2013
- **Last updated:** 01/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | SD0404 | — | SC |