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	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH19380	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2015690	OTHER	PK

General Provider Information

NPI Number	:	1124045539
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	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5216 RED BUG LAKE RD
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4912
Country	:	US
Telephone Number	:	407-699-7055
Fax Number	:

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/30/2023

Similar Medicare Providers

1790033769 — PARMINDER NARANG
Practice Location Address:

5220 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-4912

Practice Phone: 407-706-3434
Practice Fax:

1760986509 — WINTER SPRINGS FAMILY DENTAL, P.A.
Practice Location Address:

5220 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-4912

Practice Phone: 772-231-6004
Practice Fax: 772-231-7249

1588207278 — AISSA JONES PHARMD
Practice Location Address:

5216 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-4912

Practice Phone: 407-699-7055
Practice Fax: 407-699-7060

1467095067 — MR. MICHAEL HUNG LE RPH
Practice Location Address:

5216 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-4912

Practice Phone: 407-699-7055
Practice Fax:

1205626710 — WINTER SPRINGS FAMILY DENTISTRY PLLC
Practice Location Address:

5220 RED BUG LAKE RD
WINTER SPRINGS, FL
32708-4912

Practice Phone: 407-706-3434
Practice Fax:

1477507960 — REGIONAL HEALTH SERVICES LLC
Practice Location Address:

1991 FLORIDA AVE SW
DENHAM SPRINGS, LA
70726-4912

Practice Phone: 225-629-3000
Practice Fax: 225-629-3030

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 © 2007-2025 (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.