Provider Information for 1275550402
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WALMART INC.
Other Names:Doing Business As:WALMART PHARMACY 10-1778Organization Subpart: NO
NPI: 1275550402
Last Updated: 2018-07-19
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
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| NPI | 1275550402 | ||||||||||||||||
| Enumeration Date | 2006-07-16 | ||||||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Authorized Official Information | Name: SARAH LITTLE Title: Director of Healthcare Contracting Phone: 4792772500 | ||||||||||||||||
| Mailing Address | 702 SW 8TH STREET BENTONVILLE, AR 72716-0445 United States Phone: | Fax: | ||||||||||||||||
| Primary Practice Address | 321 YELLOWSTONE AVE CODY, WY 82414-9315 United States Phone: 307-527-5746 | Fax: | ||||||||||||||||
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