Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-2033
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
1000 OLD RED TRL NE, MANDAN, ND 58554-1591
(701) 354-6964
(701) 354-6965
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140892
PK
—
Enumeration date
06/20/2013
Last updated
06/23/2013
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