Wal-Mart Pharmacy 10-1891

LBN: Wal-Mart Stores East Lp
Wal-Mart Pharmacy 10-1891 is an health care organization with primary practice located at 420 Buckland Hills Dr , Manchester CT 06042-8755. 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 (860) 644-5105, or through Little, Sarah via phone (479) 277-2500.

Contact Information

Primary practice address
420 Buckland Hills Dr Manchester CT 06042-8755
Phone: (860) 644-5105
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 PCY0001455 Connecticut

Profile Details

NPI number 1417974791
LBN Legal business name Wal-Mart Stores East Lp
DBA Doing business as Wal-Mart Pharmacy 10-1891
Authorized official Little, Sarah
Entity Organization
Organization subpart 1 No
Enumeration date Jul 16th, 2006
Last updated Feb 16th, 2017 - about 8 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 1417974791 NPPES
Other 2000248 PK
MEDICAID 004129161 PK
MEDICAID 940004129161 PK

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