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Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-5987
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
494 W INTERSTATE 30, ROYSE CITY, TX 75189-7527
(972) 635-2734
(972) 635-2731
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30050
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154109
PK
—
05
—
470196
—
TX
Enumeration date
09/15/2015
Last updated
08/30/2023
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