Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3078
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
290 STATE ROUTE 18, EAST BRUNSWICK, NJ 08816-1995
(732) 387-1062
(732) 387-1061
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00736400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0451819
—
NJ
01
—
2146462
PK
—
Enumeration date
05/23/2014
Last updated
08/30/2023
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