Organization
WAL-MART PUERTO RICO INC
Active
Other names
SAMS PHARMACY 10-4806
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
CARR. 3 KM. 15.2 BO. CANOVANILLAS, CAROLINA, PR 00987
(787) 769-1989
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17-F-2543
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2087572
PK
—
Enumeration date
09/11/2007
Last updated
02/16/2017
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