Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-4583
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3925 PELHAM RD, GREENVILLE, SC 29615-5004
(864) 288-8081
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
10164
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117047
PK
—
05
—
710164
—
SC
Enumeration date
08/22/2008
Last updated
08/29/2023
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