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Organization

WAL MART

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAJ PANDYA (STORE MANAGER)
(864) 834-7179
Entity
Organization

Contact information

Practice address
9 BENTON RD, TRAVELERS RST, SC 29690-2168
(864) 834-7179
Mailing address
9 BENTON RD, TRAVELERS RST, SC 29690-2168
(864) 834-7179

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
4637
SC

Other

Enumeration date
04/15/2014
Last updated
04/15/2014
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