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Organization

WALMART INC.

Active
Other names
WALMART PHARMACY 10-2882
Organization subpart
No

Provider details

NPI number
Authorized official
MATT MCMULLIN (DIRECTOR OF HEALTHCARE CONTRACTING)
(479) 371-8711
Entity
Organization

Contact information

Practice address
9451 DUNKIRK LN N, MAPLE GROVE, MN 55311-5447
(763) 416-2300
(763) 416-2302
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
261984
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2048187
PK
05
584185200
MN
Enumeration date
07/16/2006
Last updated
09/26/2024
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