Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4432
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1818 NORTHWEST BLVD, NEWTON, NC 28658-3719
(828) 468-6243
(828) 468-6241
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
12767
NC
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467823096
—
NC
01
—
2155720
PK
—
Enumeration date
10/08/2015
Last updated
02/20/2017
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