Organization
WAL-MART STROES INC
Active
Other names
Walmart Pharmacy 10-3878
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (DIR. HEALTHCARE CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
5 HIGHWAY 124 W, DAMASCUS, AR 72039-9251
(501) 335-7270
(501) 335-7267
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20788
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148767
PK
—
Enumeration date
10/07/2014
Last updated
12/22/2015
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