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Contact Information

WAL-MART STORES EAST LP
6361 HIGHWAY 72 EAST
GURLEY, AL35748
 Phone: 256-776-4404
 Fax: 479-277-4331
 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
Indicates primary specialty

NPI Profile & details for WAL-MART STORES EAST LP

NPI # 1730588104
LBN Legal business name WAL-MART STORES EAST LP
Authorized official LAURA LEVINE - (DIR HEALTHCARE CONTRACT&ENROLL)
Entity Organization
Organization subpart 1 No
Enumeration date 08/21/2014
Last updated 02/02/2015 - About 11 years ago
Identifiers
AL License # 114431
AL Medicaid 167487
Other 2147623 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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