# WALMART

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** N/A
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1154724540
- **Legal business name:** N/A
- **Authorized official:** DR. RAED ALZAHRANI (PHARMACY MANAGER)
- **Authorized official phone:** (503) 929-0199

## Contact information

- **Practice address:** 3290 S SANTIAM HWY, LEBANON, OR 97355-3737
- **Practice address phone:** (541) 258-7440
- **Mailing address:** 1995 TRADE ST SE, SALEM, OR 97301-8265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/30/2014
- **Last updated:** 09/30/2014