Organization

Wal-mart Stores East Lp

May also be knows as Walmart Pharmacy 10-6170

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

Legal Business Name

Wal-mart Stores East Lp

Also Known As

Walmart Pharmacy 10-6170

NPI Number

1912324492

NPI Type

Organization

Enumeration Date

03/24/2014

Specialties

(Taxonomies)

Code

3336C0003X
332B00000X

Primary Taxonomy

Yes
No

Licenses

State

Oklahoma

License Number

2-6632

Contact
Information

Purpose

Mailing
Location

Address

702 SW 8TH ST
3139 S HARVARD AVE

City

Bentonville
Tulsa

State

AR
OK

Postal Code

72716-0445
74135-4402

Country

US
US

Telephone Number

(479) 277-1242
(918) 984-6291

Authorized Official

Name

Sarah Little

Title or Position

DIRECTOR OF HEALTHCARE CONTRACTING

Telephone Number

(479) 277-2500

Identifiers

Identifier

1002631610F
2144863

Identifier State

OK
Unknown

Identifier Issuer

Unknown
PK

Health Information Exchange

Endpoint Type

CONNECT

Endpoint

https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service

Endpoint Description

2.16.840.1.113883.3.667.2

Use

Other

Content Type

Unknown

Affiliation

Y

Endpoint Location

Ability Network100 N 6th St Ste 900AMinneapolis, MN554031516US

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

Data last updated by provider on 08/30/2023

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