Organization Name: | WAL-MART STORES EAST LP |
NPI Number: | 1194197533 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA LEVINE (DIR HEALTHCARE CONCTRACT & ENROLLME) |
Mailing Address: | 102 Gateway Crossing Blvd Radcliff |
State: | KY US |
Postal Code: | 401609204 |
Phone Number: | 2703513625 |
Fax Number: | |
NPI Enumeration Date: | 10/26/2015 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |