Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-3447
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3657 E MAIN ST, WHITEHALL, OH 43213-2924
(614) 239-7805
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
021652600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2080566
PK
—
05
—
2720238
—
OH
Enumeration date
12/27/2006
Last updated
02/20/2017
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