Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4195
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (SENIOR DIRECTOR, ENROLLMENT)
(479) 277-2500
Entity
Organization
Contact information
Practice address
14185 MACK HARRINGTON DR, CHOCTAW, OK 73020-2035
(405) 390-4495
(405) 390-4745
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1-6621
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231610R
—
OK
01
—
2145358
PK
—
Enumeration date
03/27/2014
Last updated
06/05/2025
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