Organization

Wal-mart Stores East Lp

May also be knows as Walmart Pharmacy 10-0517

Community/Retail Pharmacy in Mustang, OK(View on Map)

Legal Business Name

Wal-mart Stores East Lp

Also Known As

Walmart Pharmacy 10-0517

NPI Number

1043237159

NPI Type

Organization

Enumeration Date

07/16/2006

Specialties

(Taxonomies)

Code

3336C0003X
332B00000X
333600000X

Primary Taxonomy

Yes
No
No

Licenses

State

Oklahoma

License Number

264702

Contact
Information

Purpose

Mailing
Location

Address

702 SW 8TH ST
951 E STATE HIGHWAY 152

City

Bentonville
Mustang

State

AR
OK

Postal Code

72716-0445
73064-5119

Country

US
US

Telephone Number

N/A
(405) 376-4525

Authorized Official

Name

Sarah Little

Title or Position

DIRECTOR OF HEALTHCARE CONTRACTING

Telephone Number

(479) 277-2500

Identifiers

Identifier

100238070A
2073927

Identifier State

OK
Unknown

Identifier Issuer

Unknown
PK

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 02/20/2017

Provider Address

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