Wal-Mart Pharmacy 10-1277

LBN: Wal-Mart Stores East Lp
Wal-Mart Pharmacy 10-1277 is an health care organization with primary practice located at 611 State Highway 54 , Black River Falls WI 54615-5453. 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 (715) 284-9115, or through Little, Sarah via phone (479) 277-2500.

Contact Information

Primary practice address
611 State Highway 54 Black River Falls WI 54615-5453
Fax:
Website:
Authorized official contact:
Name: Little, Sarah

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 8703-42 Wisconsin

Profile Details

NPI number 1417975111
LBN Legal business name Wal-Mart Stores East Lp
DBA Doing business as Wal-Mart Pharmacy 10-1277
Authorized official Little, Sarah
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2006
Last updated Aug 29th, 2023 - about last year

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 1417975111 NPPES
Other 2114844 PK
MEDICAID 33160600 PK

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