Wal-Mart Stores East, Lp.
Specialty details in registry · Georgetown, SC
At a glance
1310 N Fraser St, Georgetown, SC 29440-2800
NPPES record updated Sep 15, 2025. Public records can lag behind changes at a practice.
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Insurance participation and appointment availability are not established by these public records.
Practice location
1310 N Fraser StGeorgetown, SC 29440-2800
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 156FX1800X
- Enumeration date
- Dec 1, 2023
- Record updated
- Sep 15, 2025
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
156FX1800X · Primary
Specialty details in registry
332H00000X
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
1310 N Fraser StGeorgetown, SC 29440-2800
- Phone
- (843) 546-8946
- Fax
- (843) 527-5019
Mailing address
702 SW 8TH STBENTONVILLE, AR 727160445
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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