Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-3007
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
139 N HIGHWAY 49, RICHFIELD, NC 28137-5738
(450) 672-5760
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
11026
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0845455
—
NC
01
—
2129924
PK
—
Enumeration date
04/11/2011
Last updated
08/01/2013
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