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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-5614
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
4904 COLLEYVILLE BLVD, COLLEYVILLE, TX 76034-3968
(817) 770-8339
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28260
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558611442
—
TX
01
—
2137079
PK
—
05
—
469165
—
TX
Enumeration date
09/18/2012
Last updated
08/30/2023
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