Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-5649
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
299 VALLEY GATE DR, WARRINGTON, PA 18976-2745
(215) 488-9025
(215) 488-9024
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PP482608
PA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007455310384
—
PA
01
—
2155733
PK
—
Enumeration date
10/06/2015
Last updated
08/30/2023
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