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Organization

WAL-MART STORES EAST LP

Active
Other names
Walmart Pharmacy 10-4601
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization

Contact information

Practice address
3331 RINCONADA BLVD, LAS CRUCES, NM 88011-7193
(575) 680-3779
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 273-4885
(479) 277-4331

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
PH00003526
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2140297
PK
Enumeration date
04/23/2013
Last updated
08/28/2023
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