Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-5912
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
21151 S DIXIE HWY, MIAMI, FL 33189-2724
(305) 964-4207
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
PH27039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009473400
—
FL
01
—
2141456
PK
—
Enumeration date
08/01/2013
Last updated
08/30/2023
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