Wal-Mart Pharmacy 10-3403

LBN: Wal-Mart Stores East Lp
Wal-Mart Pharmacy 10-3403 is an health care organization with primary practice located at 3615 Marietta Hwy , Dallas GA 30157-9472. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Wal-Mart Stores East Lp can be contacted via phone (770) 445-9096, or through Little, Sarah via phone (479) 277-2500.

Contact Information

Primary practice address
3615 Marietta Hwy Dallas GA 30157-9472
Phone: (770) 445-9096
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Little, Sarah
Phone: (479) 277-2500

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHRE009000 Georgia

Profile Details

NPI number 1285651539
LBN Legal business name Wal-Mart Stores East Lp
DBA Doing business as Wal-Mart Pharmacy 10-3403
Authorized official Little, Sarah
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2006
Last updated Sep 28th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285651539 NPPES
Georgia MEDICAID 000940541Q
Georgia MEDICAID 00940541Q
Georgia Other 2016149
Georgia MEDICAID PHRE009000

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