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	156FX1800X	Optician
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1568594570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES EAST, LP

Provider Business Mailing Address
First Line	:	702 SW 8TH STREET
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0235
Country	:	US
Telephone Number	:	479-277-1175
Fax Number	:	479-277-8174

Provider Business Practice Location Address
First Line	:	1481 US HWY 17 NORTH
Second Line	:
City	:	MT. PLEASANT
State	:	SC
Zip	:	29464
Country	:	US
Telephone Number	:	843-881-6100
Fax Number	:

Authorized Official
Title or Position	:	NPI ASSOCIATE
Name	:	SABRINA N SUTTON
Credential	:
Telephone Number	:	479-277-1175

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1801763982 — HOME HAVEN CARE
Practice Location Address:

11 EWALL ST
MT PLEASANT, SC
29464-3062

Practice Phone: 843-209-8500
Practice Fax:

1093854218 — SUSAN CAO M.D.
Practice Location Address:

180 WINGO WAY STE 205
MT PLEASANT, SC
29464-1811

Practice Phone: 843-256-7109
Practice Fax:

1619519360 — ANNA GUITTON GLENN PA-C
Practice Location Address:

1625 HOSPITAL DR
MT PLEASANT, SC
29464-3698

Practice Phone: 843-849-1551
Practice Fax: 843-884-0629

1508491598 — CAROLINE ROSE KHADER CNM/WHNP
Practice Location Address:

1300 HOSPITAL DRIVE CHARLESTON BIRTH PLACE , SUITE #270
MT. PLEASANT, SC
29464

Practice Phone: 843-818-1123
Practice Fax:

1679090500 — RACHEL NOVAKOVICH DPT
Practice Location Address:

325 SLATE LN APT 8107
MT PLEASANT, SC
29464-6709

Practice Phone: 412-780-4035
Practice Fax:

1982608725 — JOHN J CHOMYN M.D.
Practice Location Address:

2000 HOSPITAL DR
MT PLEASANT, SC
29464

Practice Phone: 843-792-1414
Practice Fax:

1598760332 — MATTHEW DOUGLAS MCLAREN MD
Practice Location Address:

180 WINGO WAY STE 105
MT PLEASANT, SC
29464-1810

Practice Phone: 855-527-7246
Practice Fax: 866-229-5063

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.