# WAL-MART PUERTO RICO INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WAL-MART STORES INC
- **Other names:** WAL-MART PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033132113
- **Legal business name:** WAL-MART STORES INC
- **Authorized official:** LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** CARR 194 KM 2 0, FAJARDO, PR 00738
- **Practice address phone:** (787) 863-7404
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 07F2313 | PR | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 12/14/2012