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Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-5627
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3900 W POWELL BLVD, GRESHAM, OR 97030-6048
(503) 405-9214
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
RP-002719-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135489
PK
—
05
—
500654686
—
OR
Enumeration date
06/05/2012
Last updated
09/19/2025
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