Provider Information for 1144609611
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WAL-MART STORES EAST LP
Other Names:Doing Business As:WALMART PHARMACY 10-7296Organization Subpart: NO
NPI: 1144609611
Last Updated: 2018-07-19
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Details
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NPI | 1144609611 | ||||||||||||||||
Enumeration Date | 2015-05-29 | ||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||
Status | Active | ||||||||||||||||
Authorized Official Information | Name: SARAH LITTLE Title: Director of Healthcare Contracting Phone: 4792772500 | ||||||||||||||||
Mailing Address | 702 SW 8TH ST MAILSTOP 0445 BENTONVILLE, AR 72716-6209 United States Phone: 479-204-8550 | Fax:479-277-4331 | ||||||||||||||||
Primary Practice Address | 2794 HICKORY BLVD HUDSON, NC 28638-9101 United States Phone: 828-572-6019 | Fax:818-572-6020 | ||||||||||||||||
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