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
1511 GRANT AVE, GARDNERVILLE, NV 89410-7824
(775) 782-6393
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-0709
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH02899
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138056
PK
—
Enumeration date
11/19/2012
Last updated
08/29/2023
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