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Organization
WAL-MART STORES, INC.
Active
Organization
WAL-MART STORES, INC.
Active
Other names
Wal-Mart Pharmacy 10-2075
Organization subpart
No
Provider details
NPI number
Authorized official
DEB LAUVER (SPECIALIST PLAN ENROLLMENT)
(479) 204-8741
Entity
Organization
Contact information
Practice address
20120 PINEBROOK BLVD, BEND, OR 97702-2537
(541) 389-5440
(541) 389-5382
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8741
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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