Organization
WAL-MART PUERTO RICO, INC.
Active
Parent organization
WAL-MART STORES, INC.
Other names
Wal-Mart Pharmacy 10-5803
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
AMY POWERS (SPECIALIST, PLAN ENROLLMENT)
(479) 204-0709
Entity
Organization
Contact information
Practice address
CALLE LABRA, ESQUINA CORCHADO, SAN JUAN, PR 00936
(787) 641-5606
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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