Organization
WAL-MART STORES, INC
Active
Parent organization
WAL-MART STORES, INC
Other names
Wal-Mart Pharmacy 10-4060
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC
Authorized official
DEB LAUVER (SPECIALIST PLAN ENROLLMENT)
(479) 204-8741
Entity
Organization
Contact information
Practice address
671 E APACHE BLVD, SUITE 128, TEMPE, AZ 85281-6717
(480) 967-2307
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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