Organization
WAL-MART STORES, INC.
Active
Parent organization
WAL-MART STORES INC
Other names
WAL-MART PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DIANNA PAINTER (TP ENROLLMENT SPECIALIST)
(479) 277-1238
Entity
Organization
Contact information
Practice address
912 11TH STREET EAST, BOTTINEAU, ND 58318
(701) 228-5930
Mailing address
MAIL STOP 0445, 702 SW 8TH ST, BENTONVILLE, AR 72716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3504481
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/16/2008
Last updated
02/06/2009
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