Organization
WAL-MART STORES EAST LP
Active
Other names
Wal-Mart Pharmacy 10-2328
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2014 WADE HAMPTON BLVD, GREENVILLE, SC 29615-1037
(864) 214-8703
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
14838
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141067
PK
—
05
—
714838
—
SC
Enumeration date
07/05/2013
Last updated
08/29/2023
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