Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-5615
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
11800 HIALEAH GARDENS BLVD, HIALEAH GARDENS, FL 33018-4235
(305) 913-1173
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26357
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008301000
—
FL
01
—
2136759
PK
—
Enumeration date
09/04/2012
Last updated
08/30/2023
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