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Wal-mart Stores East Lp

Wal-mart Stores East Lp is a health care provider in Bentonville, AR. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 61 Plaza Drive, Kimball, WV 24853, US
Practice Location Phone304-585-7820
Practice Location Fax
Legal Business NameWAL-MART STORES EAST LP
Other Organization NameWAL-MART PHARMACY 10-3811
Other Organization Name TypeDoing Business As Name
NPI ?1710905401
Entity TypeOrganization
Enumeration Date ? Jul 18, 2006
Last Update Date ? Jul 11, 2013
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Wal-mart Stores East Lp

SpecialtySpecializationLicenseLicense State
Durable Medical Equipment & Medical Supplies
Pharmacy
PharmacyCommunity/Retail Pharmacy MP0552327West Virginia

legacy-id-icon Legacy Provider IDs of Wal-mart Stores East Lp

Provider IdIssuer StateIssuer TypeIssuer
2111563OtherPK
552327West VirginiaMedicaid
3810003883West VirginiaMedicaid

official-icon Authorized Official of Wal-mart Stores East Lp

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Wal-mart Stores East Lp's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Laura Levine
Authorized Official Title/PositionMGR OF GOVERNMENT CONTRACTING
Authorized Official Phone Number479-204-8550