Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3167
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4301 CHEF MENTEUR HWY, NEW ORLEANS, LA 70126-4919
(504) 434-6078
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 204-8550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006923-RC
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146671
PK
—
05
—
2203011
—
LA
Enumeration date
06/19/2014
Last updated
08/30/2023
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