Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4671
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4110 SHALLOWFORD RD, CHATTANOOGA, TN 37411-1110
(423) 242-0019
(423) 242-0006
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-1258
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5724
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155642
PK
—
Enumeration date
11/05/2015
Last updated
02/15/2017
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