| Name: | WAL-MART STORES EAST, LP |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Limited Partnership |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Jan 2002 (23 years ago) |
| Identification Number: | 000122359 |
| Place of Formation: | DELAWARE |
| Principal Address: | 702 SW 8TH STREET, BENTONVILLE, AR, 72716, USA |
| Purpose: | RETAIL SALES |
| NAICS: | 452210 - Department Stores |
| Fictitious names: |
Wal-Mart Neighborhood Market (trading name, 2004-02-24 - ) Wal-Mart Supercenter (trading name, 2004-02-24 - ) Wal-Mart (trading name, 2004-01-08 - ) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083779409 | 2006-12-26 | 2023-09-07 | 702 SW 8TH ST, BENTONVILLE, AR, 727160445, US | 51 SILVER SPRING ST, PROVIDENCE, RI, 029042557, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 401-272-5340 |
Authorized person
| Name | SARAH LITTLE |
| Role | DIRECTOR OF HEALTHCARE CONTRACTING |
| Phone | 4792772500 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PHA00375 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2089571 |
| Issuer | MEDICAID |
| Number | WM64210 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 450 VETERANS MEMORIAL PARKWAY SUITE 7A, EAST PROVIDENCE, RI, 02914, USA |
| Number | Name | File Date |
|---|---|---|
| 202452095760 | Annual Report | 2024-04-23 |
| 201324203940 | Statement of Change of Registered/Resident Agent Office | 2013-06-17 |
| 201314363520 | Statement of Change of Registered/Resident Agent Office | 2013-03-25 |
| 201178848810 | Statement of Change of Registered/Resident Agent Office | 2011-05-13 |
| 200943319300 | Statement of Change of Registered/Resident Agent Office | 2009-02-27 |
| 202039422640 | Statement of Change of Registered/Resident Agent | 2004-03-31 |
| 202039422730 | Fictitious Business Name Statement | 2004-02-24 |
| 202039422910 | Fictitious Business Name Statement | 2004-02-24 |
| 202039423070 | Fictitious Business Name Statement | 2004-01-08 |
| 202039423160 | Application for Certificate of Registration | 2002-01-14 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
