Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-4697
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3227 OLD FOREST RD, LYNCHBURG, VA 24501-2325
(434) 385-7357
Mailing address
1 CUSOTMER DR, MS 0445, BENTONVILLE, AR 72716-0445
(479) 277-1238
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0201004350
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063730133
—
VA
01
—
2125151
PK
—
Enumeration date
05/13/2010
Last updated
09/29/2025
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