Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-4533
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
105 CHICKASAW RIDGE DR, OAKLAND, TN 38060-6206
(901) 465-0466
(901) 465-0393
Mailing address
702 SW 8TH ST, MS 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4490
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2095345
PK
—
Enumeration date
01/16/2008
Last updated
08/29/2023
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