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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-2863
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACTING)
(479) 277-8550
Entity
Organization
Contact information
Practice address
1010 N MAIN ST, WINTERS, TX 79567-3205
(325) 754-4028
(325) 754-4723
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1240
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29375
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147974
PK
—
Enumeration date
09/11/2014
Last updated
04/15/2015
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