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Organization

WAL-MART STORES EAST LP

Active
Other names
WALMART PHARMACY 10-5095
Organization subpart
No

Provider details

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

Contact information

Practice address
495 FLATBUSH AVE, HARTFORD, CT 06106-3601
(860) 953-0725
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PCY.0001938
CT
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004248606
CT
05
008047184
CT
01
2002638
PK
Enumeration date
07/16/2006
Last updated
08/30/2023
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