Organization
WAL-MART STORES EAST LP
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-2573
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MANAGER, GOVT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
303 GOLDSBORO ST, PIKEVILLE, NC 27863-9649
(919) 242-8718
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
11422
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245574953
—
NC
01
—
2138199
PK
—
Enumeration date
11/19/2012
Last updated
12/20/2013
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