Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-2786
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
9500 E US HIGHWAY 36, AVON, IN 46123-7366
(317) 209-8204
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
60005794A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200466960
—
IN
05
—
200466960A
—
IN
01
—
2024679
PK
—
Enumeration date
07/16/2006
Last updated
08/29/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us