Provider Demographics
NPI:1609126242
Name:STRATTON, WALTER (RPH)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:
Last Name:STRATTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2963 DEER POINT DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-6232
Mailing Address - Country:US
Mailing Address - Phone:843-568-3717
Mailing Address - Fax:
Practice Address - Street 1:2963 DEER POINT DR
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-6232
Practice Address - Country:US
Practice Address - Phone:843-568-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist