Provider Information for 1831116250
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WALMART INC.
Other Names:Doing Business As:WALMART PHARMACY 10-0039Organization Subpart: NO
NPI: 1831116250
Last Updated: 2023-11-06
Certification Date: 2023-11-06
Certification Date: 2023-11-06
Details
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NPI | 1831116250 | ||||||||||||||||||||
Enumeration Date | 2006-07-16 | ||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||
Status | Active | ||||||||||||||||||||
Authorized Official Information | Name: MATTHEW MCMULLIN Title: Director, Contracting Phone: 4793718711 | ||||||||||||||||||||
Mailing Address | 702 SW 8TH ST BENTONVILLE, AR 72716-0445 United States Phone: 479-204-8550 | Fax:479-277-4331 | ||||||||||||||||||||
Primary Practice Address | 2500 S MAIN ST FORT SCOTT, KS 66701-8724 United States Phone: 620-223-5051 | Fax:620-223-2193 | ||||||||||||||||||||
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