Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-4167
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2501 UNIV COMMONS WAY, KNOXVILLE, TN 37919-5584
(865) 824-4459
(865) 824-4454
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00005395
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146665
PK
—
Enumeration date
06/19/2014
Last updated
02/15/2017
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