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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
WALMART PHARMACY 10-3229
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
3800 US HIGHWAY 287 W, VERNON, TX 76384-3280
(940) 552-8069
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
21641
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100243640E
—
OK
01
—
2095106
PK
—
05
—
469567
—
TX
Enumeration date
07/18/2006
Last updated
08/30/2023
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