Organization
WALMART INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2844 N BROADWAY ST, CHICAGO, IL 60657-6017
(773) 687-4513
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05018094
IL
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138047
PK
—
Enumeration date
11/15/2012
Last updated
08/10/2021
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