Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-0072
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCMULLIN (DIRECTOR, CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
2710 N BROADWAY ST, PITTSBURG, KS 66762-2625
(620) 231-0756
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-08014
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100433120A
—
KS
01
—
2025967
PK
—
05
—
6010831834
—
KS
Enumeration date
07/16/2006
Last updated
11/06/2023
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