Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-4524
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
5360 DIXIE HWY, LOUISVILLE, KY 40216-1564
(502) 447-4745
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PO7239
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035003
PK
—
Enumeration date
10/31/2007
Last updated
08/29/2023
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