Organization
WAL-MART STORES EAST LP
Active
Other names
Walmart Pharmacy 10-3424
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2653 VALLEYDALE RD, HOOVER, AL 35244-2026
(205) 582-6188
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 277-2500
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
114443
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186879 DME
—
AL
01
—
2148904
PK
—
Enumeration date
10/23/2014
Last updated
02/16/2017
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