Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4588
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3101 W PRINCETON ST, ORLANDO, FL 32808-5600
(407) 445-4047
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24491
FL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2119700
—
FL
01
—
2123562
PK
—
Enumeration date
01/22/2010
Last updated
08/29/2023
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