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	PHRE006936	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	2015886	OTHER	PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841217262
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	:	1785 COBB PKWY S
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-9288
Country	:	US
Telephone Number	:	770-955-6836
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	:	08/28/2023

Similar Medicare Providers

1346321718 — WAL-MART STORES EAST, LP
Practice Location Address:

1785 COBB PKWY S
MARIETTA, GA
30060-9288

Practice Phone: 770-955-0626
Practice Fax:

1972961845 — COBB EYE ASSOCIATES I
Practice Location Address:

1785 COBB PKWY S
MARIETTA, GA
30060-9288

Practice Phone: 770-955-5019
Practice Fax: 770-955-7349

1881356269 — MICHAEL ZHOU
Practice Location Address:

1785 COBB PKWY S # S
MARIETTA, GA
30060-9288

Practice Phone: 770-955-6836
Practice Fax:

1548227929 — CHIROPRACTIC CENTER OF MARIETTA PC
Practice Location Address:

1135 S MARIETTA PKWY SE
MARIETTA, GA
30060-2811

Practice Phone: 770-422-9288
Practice Fax: 770-422-4626

1780641167 — RANSOM WAYNE GABY DC
Practice Location Address:

1135 S MARIETTA PKWY SE
MARIETTA, GA
30060-2811

Practice Phone: 770-422-9288
Practice Fax: 770-422-4626

1871946129 — DR. MARGARET TERESA SLIWKA D.C.
Practice Location Address:

1135 S MARIETTA PKWY SE
MARIETTA, GA
30060-2811

Practice Phone: 770-422-9288
Practice Fax:

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.