# WAL-MART STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Pharmacy 10-2430
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164766846
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 1424 W 47TH ST, CHICAGO, IL 60609-3232
- **Practice address phone:** (561) 509-2026
- **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 | 054018102 | IL | Yes |

## Other

- **Enumeration date:** 11/19/2012
- **Last updated:** 02/20/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2138033 | PK | — |