Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-4637
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3900 E HILLSIDE DR, BROKEN ARROW, OK 74014-6713
(918) 355-1076
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-5449
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100231610L
—
OK
01
—
2121175
PK
—
Enumeration date
07/21/2009
Last updated
08/29/2023
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