Organization
WAL-MART STORES INC
Active
Other names
Walmart Pharmacy 10-5666
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2510 CANTRELL RD, LITTLE ROCK, AR 72202-2116
(501) 265-0065
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20676
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196754407
—
AR
01
—
2135115
PK
—
Enumeration date
05/03/2012
Last updated
02/16/2017
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