Skip Navigation Link. Please press insert + down arrow if jaws does not start reading the content.

Provider Information for 1144609611


The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

WAL-MART STORES EAST LP

Other Names:  
Doing Business As: 
WALMART PHARMACY 10-7296

Organization Subpart: NO

NPI: 1144609611
Last Updated: 2018-07-19
Certification Date:

Details

NameValue
NPI1144609611
Enumeration Date2015-05-29
NPI TypeNPI-2 Organization
StatusActive
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
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDNC1144609611
MEDICAIDNC1144609611 DME
Other (non-Medicare)2152266PK
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 332B00000X - Durable Medical Equipment & Medical Supplies
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyNC12631