Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3035
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
310 RIGGS RD NE, WASHINGTON, DC 20011-2534
(202) 756-4417
(202) 756-4416
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
RX0000095
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153861
PK
—
05
—
621047300
—
MD
Enumeration date
07/09/2015
Last updated
08/30/2023
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