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	109990	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1992136	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	:	1871511394
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	:	3700 US HIGHWAY 431 N
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2362
Country	:	US
Telephone Number	:	334-291-1814
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	08/29/2023

Similar Medicare Providers

1467559088 — DR. JONATHAN GUY HARP O.D.
Practice Location Address:

3700 HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-291-6379
Practice Fax: 334-291-9109

1215010145 — WAL-MART STORES EAST, LP
Practice Location Address:

3700 HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-291-1700
Practice Fax:

1659125177 — DR. EVETTE RANSAW BS, MS, DDS
Practice Location Address:

3732 US HIGHWAY 431 N
PHENIX CITY, AL
36867-2362

Practice Phone: 334-408-3467
Practice Fax:

1518896331 — STEPHANIE ROSEMARIE PITTARO
Practice Location Address:

2911 SUMMIT AVE
UNION CITY, NJ
07087-2362

Practice Phone: 201-972-5739
Practice Fax:

1629924931 — ESSEX THERAPY, LLC
Practice Location Address:

2911 SUMMIT AVE
UNION CITY, NJ
07087-2362

Practice Phone: 201-290-8326
Practice Fax:

1659539633 — DR. HOLGER G ARMAS M.D.
Practice Location Address:

2911 SUMMIT AVE , SUITE 105
UNION CITY, NJ
07087-2362

Practice Phone: 201-558-7816
Practice Fax: 201-223-5745

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.