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Organization

WAL-MART STORES EAST LP

Active
Other names
WALMART PHARMACY 10-5129
Organization subpart
No

Provider details

NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization

Contact information

Practice address
6210 ANNAPOLIS RD, LANDOVER HILLS, MD 20784-1308
(301) 773-7596
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
P04537
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2038218
PK
05
4132564 00
MD
05
413256400
MD
Enumeration date
03/14/2007
Last updated
08/30/2023
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