Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3885
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
5221 BROOK RD, RICHMOND, VA 23227-2901
(804) 264-2464
(804) 264-2575
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0201004657
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952780892
—
VA
01
—
2152249
PK
—
Enumeration date
05/26/2015
Last updated
02/15/2017
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