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Organization

WAL-MART STORES EAST LP

Active
Other names
WAL-MART PHARMACY 10-1290
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization

Contact information

Practice address
1801 US HIGHWAY 421, WILKESBORO, NC 28697-2279
(336) 667-4337
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
8024
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0975326
NC
01
2069853
PK
05
7704067
NC
05
975326
NC
Enumeration date
07/16/2006
Last updated
08/29/2023
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