Organization
WAL-MART PUERTO RICO 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
LOS DOMINICOS ESQ SABANA SECA, TOA BAJA, PR 00949-2312
(787) 261-0400
(787) 784-0636
Mailing address
702 SW 8TH ST, LEVITVILLE SHOPPING CENTER URB, 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
19-F-2551
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087582
PK
—
Enumeration date
10/23/2007
Last updated
04/03/2019
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