Organization
WAL-MART STORES INC
Active
Other names
Walmart Pharmacy 10-2430
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
1424 W 47TH ST, CHICAGO, IL 60609-3232
(561) 509-2026
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138033
PK
—
Enumeration date
11/19/2012
Last updated
02/20/2017
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