# WAL-MART STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WALMART PHARMACY 10-1818
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679590954
- **Authorized official:** LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
- **Authorized official phone:** (479) 204-8550

## Contact information

- **Practice address:** 2131 W GALENA BLVD, AURORA, IL 60506-3211
- **Practice address phone:** (630) 264-2581
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054013056 | IL | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 12/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2023428 | PK | — |