Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4388
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1211 W BROAD ST, WAYNESBORO, VA 22980-4326
(540) 943-4637
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 258-6180
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
0201004725
VA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477901676
—
VA
01
—
2160445
PK
—
Enumeration date
05/27/2016
Last updated
08/23/2023
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