Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
WAL-MART PHARMACY 10-3814
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
6525 GLACIER HWY, JUNEAU, AK 99801-7905
(907) 789-2440
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
440
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1997072
PK
—
05
—
MS0256DME
—
AK
05
—
PH5147
—
AK
Enumeration date
07/13/2007
Last updated
07/09/2013
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