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Organization

WAL-MART STORES EAST LP

Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Pharmacy 10-2375
Organization subpart
Yes

Provider details

NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization

Contact information

Practice address
4718 NASHVILLE HWY, CHAPEL HILL, TN 37034-2110
(931) 364-5005
(931) 853-5919
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
0000005507
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2148077
PK
Enumeration date
09/19/2014
Last updated
04/06/2015
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