Organization
WAL-MART STORES INC
Active
Other names
WALMART PHARMACY 10-1818
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA LEVINE (MGR OF GOVERNMENT CONTRACTING)
(479) 204-8550
Entity
Organization
Contact information
Practice address
2131 W GALENA BLVD, AURORA, IL 60506-3211
(630) 264-2581
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054013056
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2023428
PK
—
Enumeration date
07/16/2006
Last updated
12/05/2016
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