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Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
WAL-MART PHARMACY 10-4342
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
22209 ROCKSIDE RD, BEDFORD, OH 44146-1554
(216) 587-0100
Mailing address
22209 ROCKSIDE RD, BEDFORD, OH 44146-1554
(216) 587-0110
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
021791250
OH
Other
Enumeration date
01/16/2008
Last updated
12/10/2013
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