Organization
WAL-MART STORES EAST LP
Active
Other names
WALMART PHARMACY 10-3894
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2350 GREY LAG WAY, LEXINGTON, KY 40509-2477
(859) 263-0526
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P07158
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2034637
PK
—
05
—
7100004950
—
KY
05
—
7100029990
—
KY
Enumeration date
12/27/2006
Last updated
08/23/2023
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