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Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Parent organization
WALMART STORES INC
Other names
Wal Mart Pharmacies 10-1725
Organization subpart
Yes
Provider details
NPI number
Legal business name
WALMART STORES INC
Authorized official
ROBERT CHOAT (NEW STORE SYS ENROLLMENT)
(179) 273-4885
Entity
Organization
Contact information
Practice address
5331 SALEM AVE, WAL MART PHARMACIES 10-1725, TROTWOOD, OH 45426-1625
(937) 837-5240
(937) 854-3078
Mailing address
MAILSTOP 0445, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
2680500
OH
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
07/16/2006
Last updated
12/28/2009
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