Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3600
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
970 STRICKLAND BRIDGE RD, FAYETTEVILLE, NC 28304-2797
(910) 364-0159
(910) 364-0156
Mailing address
702 SW 8TH ST, 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
12114
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174927057
—
NC
01
—
2148676
PK
—
Enumeration date
10/21/2014
Last updated
08/29/2023
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