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Organization
WAL-MART STORES INC
Active
Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-3086
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DAVID BADEEN (SR DIR H&W BILLING, RECON)
(479) 277-2611
Entity
Organization
Contact information
Practice address
701 W CESAR E CHAVEZ AVE, LOS ANGELES, CA 90012-2104
(213) 337-0182
(213) 337-0174
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8741
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY 51215
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139318
PK
—
Enumeration date
03/07/2013
Last updated
03/26/2014
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