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Organization
WAL-MART PHARMACY
Active
Organization
WAL-MART PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANA RENEE HOUSTON PHARMD (STAFF PHARMACIST)
(803) 381-3103
Entity
Organization
Contact information
Practice address
4875 OLD YORK RD, ROCK HILL, SC 29732-8127
(803) 323-2091
Mailing address
4875 OLD YORK RD, ROCK HILL, SC 29732-8127
(803) 323-2091
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36649
SOUTH CAROLINA PHARMACY LICENSE
SC
Enumeration date
08/11/2016
Last updated
08/11/2016
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