Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-4607
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3735 PALOMAR CENTRE DR, LEXINGTON, KY 40513-1147
(859) 224-0495
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07226
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035004
PK
—
05
—
7100018920
—
KY
Enumeration date
11/26/2007
Last updated
08/29/2023
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