Organization
WALMART INC.
Active
Organization
WALMART INC.
Active
Other names
WALMART PHARMACY 10-1434
Organization subpart
No
Provider details
NPI number
Authorized official
MATT MCMULLIN (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 371-8711
Entity
Organization
Contact information
Practice address
707 S 8TH ST, COLORADO SPRINGS, CO 80905-1811
(719) 633-7511
(719) 328-0723
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
240000062
CO
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03000536
—
CO
01
—
2001949
PK
—
05
—
3000536
—
CO
Enumeration date
07/16/2006
Last updated
11/20/2024
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