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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
WALMART PHARMACY 10-1313
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1200 SE MILITARY DR, SAN ANTONIO, TX 78214-2851
(210) 921-1992
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21663
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2097909
PK
—
05
—
469741
—
TX
Enumeration date
07/16/2006
Last updated
08/29/2023
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