Organization
WAL-MART STORES EAST LP
Active
Organization
WAL-MART STORES EAST LP
Active
Other names
Wal-Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNA PAINTER (PHARMACY ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
3553 E ROBINSON AVE, SPRINGDALE, AR 72764
(479) 750-2903
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0423020
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/19/2008
Last updated
12/19/2008
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