Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-5669
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4140 W GREENFIELD AVE, WEST MILWAUKEE, WI 53215-1334
(414) 978-2007
(414) 978-2008
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8741
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
9187-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139277
PK
—
Enumeration date
03/06/2013
Last updated
08/30/2023
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