# WAL-MART STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES INC
- **Other names:** Wal-Mart Pharmacy 10-3097
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023352812
- **Legal business name:** WAL-MART STORES INC
- **Authorized official:** LAURA LEVINE (MANAGER GOVT CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 8235 SW APPLE WAY, PORTLAND, OR 97225-1782
- **Practice address phone:** (503) 205-9977
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-0709
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | RP-0002757-CS | OR | Yes |

## Other

- **Enumeration date:** 11/16/2012
- **Last updated:** 03/26/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2138044 | PK | — |