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
2415 N BLOOMINGTON ST, STREATOR, IL 61364-1305
(815) 672-3517
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054017736
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131522
PK
—
Enumeration date
08/09/2011
Last updated
08/29/2023
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