OrganizationWal-Mart Stores East Lp(Walmart Pharmacy 10-4504)PharmacySuppliersPractice Address312 Palisades Blvd, Birmingham, AL 35209-5148(205) 870-7170PECOS EnrollmentBased on the most recent information from CMS, provider Wal-Mart Stores East Lp does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1477687317Provider TypeOrganizationFull NameWal-Mart Stores East LpOther NameWalmart Pharmacy 10-4504SubpartNoEnumeration Date3/15/2007Last Updated2/16/2017Contact InformationPractice LocationPractice Address312 Palisades Blvd, Birmingham, AL 35209-5148Phone(205) 870-7170FaxUnlisted FaxMailing LocationMailing Address702 SW 8th St, Bentonville, AR 72716-0445PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameLittle, Sarah (Director Of Healthcare Contracting)Phone(479) 277-2500Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicense112935AlabamaCode332B00000XDescriptionDurable Medical Equipment & Medical SuppliesSuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID100039124DescriptionMedicaidIssuerUnlistedAlabamaID1996006DescriptionOtherIssuerPK