Organization
WALMART INC.
Active
Other names
WalMart Pharmacy 10-5869
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 277-2500
Entity
Organization
Contact information
Practice address
2470 W PULLMAN RD, MOSCOW, ID 83843-4034
(208) 882-1344
(208) 882-5886
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-6209
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
17913RP
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132888
PK
—
Enumeration date
11/28/2011
Last updated
09/19/2025
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