Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4441
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4400 FOREST HILL BLVD, WEST PALM BEACH, FL 33406-5720
(561) 530-1236
(561) 530-1235
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017593700
—
FL
05
—
017593701 DME
—
FL
01
—
2159713
PK
—
Enumeration date
04/14/2016
Last updated
08/29/2023
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