Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-3052
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
DAVID BADEEN (SR DIR H&W)
(479) 277-2611
Entity
Organization
Contact information
Practice address
7809 NE VANCOUVER PLAZA DR, VANCOUVER, WA 98662-6643
(360) 253-4038
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 98662-6643
(479) 204-8741
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
—
2140448
PK
—
Enumeration date
05/22/2013
Last updated
07/12/2013
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