Organization
WAL-MART STORES EAST LP
Active
Other names
Wal-Mart Pharmacy 10-5888
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3400 HARTZDALE DR, CAMP HILL, PA 17011-7213
(717) 409-3109
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
PP482472
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007455310373
—
PA
01
—
2145984
PK
—
Enumeration date
03/28/2014
Last updated
08/29/2023
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