Ellisor, Walter Gerald

Ellisor, Walter Gerald is an individual health care provider with primary practice located at 101 Professional Ave , West Columbia SC 29169-4711. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Ellisor, Walter Gerald can be contacted via phone (803) 794-6440.

Contact Information

Primary practice address
101 Professional Ave West Columbia SC 29169-4711
Phone: (803) 794-6440
Fax: (803) 739-1420
Website:
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Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 003755 South Carolina

Profile Details

NPI number 1740494095
LBN Legal business name Ellisor, Walter Gerald
Credentials RPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740494095 NPPES
South Carolina Other 003755 STATE LICENSE

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