Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-3340
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4720 E 21ST ST, TULSA, OK 74114-2109
(918) 392-7025
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
25125
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100240050G
—
OK
01
—
2077114
PK
—
Enumeration date
01/03/2007
Last updated
06/19/2025
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