Organization
WAL-MART STORES EAST, LP
Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Pharmacy 10-2095
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACTING & ENROLL)
(479) 204-8550
Entity
Organization
Contact information
Practice address
15 TOBEY RD, WAREHAM, MA 02571-1083
(508) 295-8855
(508) 295-6742
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 258-6180
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/27/2015
Last updated
08/27/2015
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