Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-5927
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3390 N HIGHWAY 67, FLORISSANT, MO 63033-1605
(314) 824-0022
(317) 824-0021
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(314) 824-0022
(314) 824-0021
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2015026287
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477931046
—
MO
01
—
2152326
PK
—
Enumeration date
05/14/2015
Last updated
08/30/2023
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