MEDICARE: CHERYL WALTON PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	12651	SC

General Provider Information

NPI Number	:	1790083582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL WALTON PHARMD

Provider Business Mailing Address
First Line	:	1223 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5821
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1223 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5821
Country	:	US
Telephone Number	:	803-731-5120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	03/03/2011

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