Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-5976
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
11505 ULYSSES ST NE, BLAINE, MN 55434-4239
(763) 354-5402
(763) 354-5396
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8741
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
264163
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205273984
—
MN
01
—
2140640
PK
—
Enumeration date
06/04/2013
Last updated
09/19/2025
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