Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3359
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
500 N DOBYS BRIDGE RD, FORT MILL, SC 29715-6815
(803) 228-6130
(803) 228-6128
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16459
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158633
PK
—
05
—
716459
—
SC
05
—
DE3830 DME
—
SC
Enumeration date
10/08/2015
Last updated
09/19/2025
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