Organization
HEROLD'S NORTH, LLC
Active
Other names
WALT'S FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WALT WALTER JETER RPH (PIC)
(184) 362-8333
Entity
Organization
Contact information
Practice address
8983 UNIVERSITY BLVD, SUITE 105, NORTH CHARLESTON, SC 29406
(843) 628-3330
(843) 300-1229
Mailing address
8983 UNIVERSITY BLVD, SUITE 105, NORTH CHARLESTON, SC 29406-7102
(843) 628-3330
(843) 300-1229
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
715074
—
SC
05
—
DE3947
—
SC
Enumeration date
01/03/2014
Last updated
09/16/2024
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