Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3338
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
203 CEDAR SPRINGS RD, SPARTANBURG, SC 29302-4639
(864) 381-6366
(864) 381-6367
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-6209
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16091
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152236
PK
—
05
—
716091
—
SC
Enumeration date
05/28/2015
Last updated
08/29/2023
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