Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-0515
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MCMULLIN (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
93 RICK RAMSEY ST, MURPHY, NC 28906-5107
(828) 837-8804
(828) 837-8815
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
07994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0205203
—
NC
05
—
205203
—
NC
01
—
2069614
PK
—
Enumeration date
07/16/2006
Last updated
08/14/2024
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