Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0171
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR, CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
950 CALIFORNIA AVE SW, CAMDEN, AR 71701-5308
(870) 836-0500
(870) 836-2010
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR8601
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126094407
—
AR
01
—
1995496
PK
—
05
—
225843716 DME
—
AR
Enumeration date
07/17/2006
Last updated
12/01/2023
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