# WALMART

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

## Provider details

- **NPI number:** 1972923738
- **Authorized official:** DR. NICOLE KATHLEEN VOSO PHARMD (PHARMACIST)
- **Authorized official phone:** (843) 232-0495

## Contact information

- **Practice address:** 125 MARYPORT DRIVE, MYRTLE BEACH, SC 29575
- **Practice address phone:** (843) 232-0495
- **Practice address fax:** (843) 232-0497
- **Mailing address:** 125 MARYPORT DRIVE, MYRTLE BEACH, SC 29575
- **Mailing address phone:** (843) 232-0495
- **Mailing address fax:** (843) 232-0497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 12598 | SC | Yes |

## Other

- **Enumeration date:** 04/21/2014
- **Last updated:** 10/14/2014