Organization
WALMART INC.
Active
Other names
Walmart Pharmacy 10-3740
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MCMULLIN (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
21475 E QUINCY AVE, AURORA, CO 80015-2882
(303) 248-4047
(303) 248-4046
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 258-2115
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.1680000100
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153533
PK
—
05
—
84189339
—
CO
Enumeration date
06/30/2015
Last updated
11/26/2024
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