Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-2442
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
5261 NE ANTIOCH RD, KANSAS CITY, MO 64119-2646
(816) 448-4002
(816) 448-4631
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2014037286
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316349590
—
MO
01
—
2148050
PK
—
Enumeration date
09/19/2014
Last updated
08/29/2023
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