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	2002009493	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2051238	OTHER		PK

General Provider Information

NPI Number	:	1780601047
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	:	2201 MICHIGAN AVE
Second Line	:
City	:	ARNOLD
State	:	MO
Zip	:	63010-2151
Country	:	US
Telephone Number	:	636-282-2657
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

1104519362 — TANGWAN NGANTEH DDS
Practice Location Address:

2231 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-287-6603
Practice Fax:

1801075668 — DR. TORRI FINDLAY DDS
Practice Location Address:

2231 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-287-1226
Practice Fax:

1720217136 — DR. ADAM J BATTAGLIA DMD
Practice Location Address:

2231 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-287-1226
Practice Fax:

1902139629 — WAL-MART STORES EAST, LP
Practice Location Address:

2201 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-282-0297
Practice Fax:

1932414323 — PIKUL OPTOMETRY, P.C.
Practice Location Address:

2201 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-287-6322
Practice Fax: 636-287-6321

1316363146 — VISIONWORKS, INC
Practice Location Address:

2263 MICHIGAN AVE
ARNOLD, MO
63010-2151

Practice Phone: 636-287-1459
Practice Fax: 636-287-1478

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.