Organization
WAL-MART STORES EAST LP
Active
Other names
WalMart Pharmacy 10-4636
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
505 OAKVILLE RD, APPOMATTOX, VA 24522-8361
(434) 352-2159
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004335
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2124535
PK
—
05
—
4355052391
—
VA
Enumeration date
04/05/2010
Last updated
08/23/2023
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