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Contact Information

WAL-MART STORES EAST LP
1801 S STATE ROAD 57
WASHINGTON, IN47501-4541
 Phone: 812-254-6195
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for WAL-MART STORES EAST LP

NPI # 1295752509
LBN Legal business name WAL-MART STORES EAST LP
Authorized official SARAH LITTLE - (DIRECTOR OF HEALTHCARE CONTRACTING)
Entity Organization
Organization subpart 1 No
Enumeration date 07/16/2006
Last updated 08/24/2023 - About 3 years ago
Identifiers
IN License # 60005040
IN Medicaid 100294710
IN Medicaid 100294710A
Other 2026673 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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