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Organization

WAL-MART STORES EAST LP

Active
Other names
WALMART PHARMACY 10-4594
Organization subpart
No

Provider details

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

Contact information

Practice address
2505 LINCOLNTON HWY, CHERRYVILLE, NC 28021-8346
(704) 435-4331
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
09975
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0366309
NC
01
2066638
PK
Enumeration date
11/23/2007
Last updated
08/29/2023
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