Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-3097
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MANAGER GOVT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
8235 SW APPLE WAY, PORTLAND, OR 97225-1782
(503) 205-9977
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
RP-0002757-CS
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138044
PK
—
Enumeration date
11/16/2012
Last updated
03/26/2014
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