Organization
WAL-MART STORES INC
Active
Organization
WAL-MART STORES INC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Pharmacy 10-5856
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
601 N WEST ST, STE 100, WICHITA, KS 67203-1239
(316) 942-8384
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 277-1238
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2-10360
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100432830F
—
KS
01
—
2131057
PK
—
Enumeration date
07/08/2011
Last updated
07/11/2013
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