Organization
WAL-MART STORES EAST LP
Active
Other names
WAL-MART PHARMACY 10-3634
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
35 PLAZA DR, TAMAQUA, PA 18252-4405
(570) 668-2481
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PP481707
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007455310249
—
PA
01
—
2081778
PK
—
Enumeration date
03/15/2007
Last updated
07/02/2025
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