Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-5968
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
5929 GEORGIA AVE NW, WASHINGTON, DC 20011-5101
(202) 719-3777
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RX0000054
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073842300
—
DC
05
—
1699100123
—
VA
01
—
2142239
PK
—
Enumeration date
09/03/2013
Last updated
08/30/2023
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