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Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-2504
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
601 FRANK SOTTILE BLVD, KINGSTON, NY 12401-1550
(845) 336-7460
(845) 336-7471
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24227
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922063
—
NY
01
—
2057213
PK
—
Enumeration date
07/16/2006
Last updated
02/25/2025
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