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Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Other names
Wal-Mart Pharmacy 10-3008
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
835 MARTIN LUTHER KING JR DR NW, ATLANTA, GA 30314-3644
(404) 460-2706
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE009887
GA
3336S0011X
Specialty Pharmacy
—
NULL
Other
Enumeration date
11/19/2012
Last updated
08/10/2021
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