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Organization
WAL-MART PUERTO RICO INC
Active
Organization
WAL-MART PUERTO RICO INC
Active
Parent organization
WAL-MART STORES INC
Other names
WAL-MART PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
CARR 194 KM 2 0, FAJARDO, PR 00738
(787) 863-7404
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
07F2313
PR
Other
Enumeration date
07/26/2006
Last updated
12/14/2012
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