MEDICARE: WAL-MART STORES EAST LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	PH28758	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2148874	OTHER		PK

General Provider Information

NPI Number	:	1538563309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES EAST LP

Provider Business Mailing Address
First Line	:	702 SW 8TH ST
Second Line	:	MAILSTOP 0445
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:	479-277-2500
Fax Number	:	479-277-4331

Provider Business Practice Location Address
First Line	:	3671 W HILLSBOROUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-5713
Country	:	US
Telephone Number	:	813-498-4097
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF HEALTHCARE CONTRACTING
Name	:	SARAH LITTLE
Credential	:
Telephone Number	:	479-277-2500

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	08/30/2023

Similar Medicare Providers

1447253414 — DR. FEDERICO KALLMANN CRUZ MD
Practice Location Address:

3617 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 844-665-4827
Practice Fax:

1174901177 — MS. HAZEL BARBARA DORSEY MS, ARNP, AGNP-C
Practice Location Address:

3617 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 844-665-4827
Practice Fax:

1538547252 — GUIDEWELL SANITAS I, LLC
Practice Location Address:

3617 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 786-408-8502
Practice Fax: 305-921-7355

1801346713 — DR. GERALD OKECHUKWU MUFORO PHARMD
Practice Location Address:

3671 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 813-498-4097
Practice Fax:

1831715366 — MS. ALEXIS VANEISHA DRAYTON APRN
Practice Location Address:

3617 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 813-675-2020
Practice Fax: 855-785-2883

1851977888 — HANNAH EILEEN GEMPLER PHARMD
Practice Location Address:

3671 W HILLSBOROUGH AVE
TAMPA, FL
33614-5713

Practice Phone: 813-498-4097
Practice Fax: 813-498-4096

Directions to “WAL-MART STORES EAST LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.