Organization
WAL-MART STORES, INC
Active
Other names
Walmart Pharmacy 10-4516
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIRECTOR)
(479) 204-8550
Entity
Organization
Contact information
Practice address
600 W MARTIN LUTHER KING BLVD, FAYETTEVILLE, AR 72701-6443
(479) 435-2008
(479) 435-2006
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/31/2015
Last updated
12/31/2015
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