Organization
WAL-MART STORES EAST , LP
Active
Other names
WAL-MART PHARMACY 10-2660
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR)
(479) 371-8711
Entity
Organization
Contact information
Practice address
72 MAIN ST, NORTH READING, MA 01864-2289
(978) 664-3207
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
CS2853
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0447552
—
MA
01
—
2038627
PK
—
05
—
447552
—
MA
Enumeration date
07/16/2006
Last updated
05/28/2024
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