Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-0202
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH LITTLE (DIRECTOR, HEALTHCARE CONTRACTING AN)
(479) 277-2500
Entity
Organization
Contact information
Practice address
16066 STATE HWY 121, FRISCO, TX 75035
(469) 675-1685
(214) 838-3953
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1258
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
31632
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2172751
PK
—
05
—
471216
—
TX
Enumeration date
09/26/2017
Last updated
08/29/2023
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