Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-3021
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOV. CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2253 S MONACO PKWY, DENVER, CO 80222-5813
(303) 323-4416
(303) 323-4410
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8741
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PDO.1680000038
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141214
PK
—
Enumeration date
07/15/2013
Last updated
11/10/2015
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